TY - JOUR
T1 - Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative
AU - Ochs-Balcom, Heather M.
AU - Hovey, Kathleen M.
AU - Andrews, Christopher
AU - Cauley, Jane A.
AU - Hale, Lauren
AU - Li, Wenjun
AU - Bea, Jennifer W.
AU - Sarto, Gloria E.
AU - Stefanick, Marcia L.
AU - Stone, Katie L.
AU - Watts, Nelson B.
AU - Zaslavsky, Oleg
AU - Wactawski-Wende, Jean
N1 - Publisher Copyright:
© 2019 American Society for Bone and Mineral Research
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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/cm2 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.
AB - 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/cm2 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.
KW - BONE
KW - BONE DENSITY
KW - DUAL-ENERGY X-RAY ABSORPTIOMETRY
KW - OSTEOPOROSIS
KW - SLEEP
KW - SLEEP DURATION
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U2 - 10.1002/jbmr.3879
DO - 10.1002/jbmr.3879
M3 - Article
C2 - 31692127
AN - SCOPUS:85074756037
SN - 0884-0431
VL - 35
SP - 261
EP - 268
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 2
ER -