The importance of the circadian system &amp; sleep for bone health

Swanson, Christine M.; Kohrt, Wendy M.; Buxton, Orfeu M.; Everson, Carol A.; Wright, Kenneth P.; Orwoll, Eric S.; Shea, Steven A.

doi:10.1016/j.metabol.2017.12.002

Cited by 102 publications

(103 citation statements)

References 127 publications

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“…(28) Further support for a biological explanation for sleep and bone associations comes from the ability of insufficient sleep to disrupt the circadian rhythm of bone turnover markers. (6,29,30) In sensitivity analyses, we stratified by race in linear regression models given the differences in sleep duration; African Americans in our sample had a higher frequency of short sleep duration and are known to have higher BMD compared with whites. (31) For whites, the sleep-BMD associations in whites are unchanged.…”

Section: Discussionmentioning

confidence: 99%

Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative

Ochs‐Balcom

Hovey

Andrews

et al. 2019

Journal of Bone and Mineral Research

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Short sleep duration, recognized as a public health epidemic, is associated with adverse health conditions, yet little is known about the association between sleep and bone health. We tested the associations of usual sleep behavior and bone mineral density (BMD) and osteoporosis. In a sample of 11,084 postmenopausal women from the Women's Health Initiative (WHI; mean age 63.3 years, SD = 7.4), we performed a cross-sectional study of the association of self-reported usual hours of sleep and sleep quality (WHI Insomnia Rating Score) with whole body, total hip, femoral neck, and spine BMD using linear regression models. We also studied the association of sleep duration and quality with dual-energy X-ray absorptiometry (DXA)-defined low bone mass (T-score < −2.5 to <−1) and osteoporosis (T-score ≤ −2.5) using multinomial regression models. We adjusted for age, DXA machine, race, menopausal symptoms, education, smoking, physical activity, body mass index, alcohol use, physical function, and sleep medication use. In adjusted linear regression models, women who reported sleeping 5 hours or less per night had on average 0.012 to 0.018 g/cm 2 significantly lower BMD at all four sites compared with women who reported sleeping 7 hours per night (reference). In adjusted multinomial models, women reporting 5 hours or less per night had higher odds of low bone mass and osteoporosis of the hip (odds ratio [OR] = 1.22; 95% confidence interval [CI] 1.03-1.45, and 1.63; 1.15-2.31, respectively). We observed a similar pattern for spine BMD, where women with 5 hours or less per night had higher odds of osteoporosis (adjusted OR = 1.28; 95% CI 1.02-1.60). Associations of sleep quality and DXA BMD failed to reach statistical significance. Short sleep duration was associated with lower BMD and higher risk of osteoporosis. Longitudinal studies are needed to confirm the cross-sectional effects of sleep duration on bone health and explore associated mechanisms. ResultsWith a mean age of 63.3 years (SD = 7.4), our postmenopausal sample is 78% non-Hispanic white. Approximately 10% of our sample reported sleeping 5 hours or less per night, and 4.5%Journal of Bone and Mineral Research n 262 OCHS-BALCOM ET AL.Model 1 adjusted for DXA serial number, age, menopausal symptoms, and race. Model 2 adjusted for model 1 plus education, smoking, physical activity, body mass index, alcohol use, physical function score, and sleep medication use.

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Section: Discussionmentioning

confidence: 99%

Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative

Ochs‐Balcom

Hovey

Andrews

et al. 2019

Journal of Bone and Mineral Research

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“…All participants had blood drawn from the cubital vein in the morning (between 7:30 and 10:00 am ) due to the known circadian variation in BTM . Blood sampling was done after a minimum of 8 hours of fasting because of postprandial reduction especially seen in CTX .…”

Section: Methodsmentioning

confidence: 99%

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

et al. 2020

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Background and aim: Adults with type 1 diabetes (T1D) have increased risk of bone fractures and decreased bone mineral density (BMD). Alterations in bone turnover have been suggested as the link between T1D and the impaired bone health. Furthermore, bone turnover has been suggested to have beneficial effects on glucose metabolism. This study aimed at describing bone turnover markers (BTM), and the relationship with glycemic control, in children and adolescents with T1D.Methods: A total of 173 (47% girls) children and adolescents aged 7.7 to 17.5 years with T1D for more than 1 year were included. Participants were evaluated by BMD together with measurements of selected BTM; two formation markers: osteocalcin (OCN) and procollagen type-1 amino-terminal propeptide (P1NP) and one resorption marker, C-terminal cross-linked telopeptide of type-1 collagen (CTX). BTM were converted into Z-scores utilizing new national references.Results: Mean OCN Z-score (−0.68 ± 1.31), P1NP Z-score (−0.33 ± 1.03) and CTX Z-score (−0.43 ± 1.10) were all significantly lower than the reference population (P < .001). No associations were seen between BTM and T1D duration. BMD Z-score was comparable to the reference population and associated with none of individual BTMs. CTX Z-score was negatively associated with HbA1c (P = .007) independent of both exogenous and residual endogenous insulin.Conclusions: Markers of bone formation and resorption were decreased in children and adolescents with T1D. CTX Z-score associated negatively with HbA1c adjusted for insulin treatment and endogenous insulin production indicating a potential

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“…Desynchrony induced by external/environmental factors is linked with high risk of serious health issues, including depressive disorders, cardiovascular disorders, diabetes and cancer 1 , 43 . Social jet lag is associated with depressive and metabolic syndromes that further enhance the consumption of nicotine, caffeine and alcohol 3 while inappropriately timed sleep is associated with endocrine, metabolic, cardiovascular, and neurological disorders 9 . Incompatibility between circadian rhythms and working periods causes sleep deprivation 44 that further causes fatigue, vigilance and attention impairments 45 (Figure 3 ).…”

Section: Major Health Problemsmentioning

confidence: 99%

“…Daily rhythm in bone turnover markers and the clock genes existence in bone cells are indications for the circadian system and sleep role in bone health maintenance. It was observed in an experiment that clock gene knockout models resulted in altered skeletal phenotypes, and repeated sleep restriction arrests resulted in bone remodeling in rats 9 .…”

Section: Major Health Problemsmentioning

confidence: 99%

“…Jet lag immediately causes fatigue and indigestion while chronic exposure to jet lag has strong impacts on spatial cognition and temporal lobe 5 . Externally induced disruption in natural sleep-wake cycles 6 and circadian rhythms is associated with neuronal dysfunction 7 , 8 , increased risk for psychiatric, cardiovascular and metabolic diseases 3 , and affects bone health 9 .…”

Section: Introductionmentioning

confidence: 99%

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Health risks associated with genetic alterations in internal clock system by external factors

Khan¹,

Nabi²,

Yao³

et al. 2018

Int. J. Biol. Sci.

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The circadian system maintains the main aspects of physiological and behavioral processes. Both circadian rhythm and sleep impact an organism's health through interaction with environmental factors. Variations in external factors influence the functionality of clock genes and disrupt 24-hour rhythmic cycle. The disrupted circadian rhythm and disregulated sleep affect an organism's health, thereby causing several disorders including cancer, depression and cardiac disorders. Considering the role of clock genes and environmental factors, extensive investigation is required focusing on pathways involved in development of life-threatening disorders. This review identifies the major risks and associated factors related with disruption in circadian system and sleep.

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The importance of the circadian system & sleep for bone health

Cited by 102 publications

References 127 publications

Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative

Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

Health risks associated with genetic alterations in internal clock system by external factors

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