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. © 2019 American Society for Bone and Mineral Research.

中文翻译：

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妇女健康倡议中，睡眠不足与骨密度低和骨质疏松症有关。

睡眠时间短，被认为是一种公共卫生流行病，与不良的健康状况有关，但对于睡眠与骨骼健康之间的关系知之甚少。我们测试了正常睡眠行为与骨矿物质密度（BMD）和骨质疏松症的关联。在来自妇女健康倡议（WHI；平均年龄63.3岁，SD = 7.4）的11,084名绝经后妇女的样本中，我们进行了一项横断面研究，该研究涉及自我报告的正常睡眠时间与睡眠质量之间的关联性（WHI失眠评分）使用线性回归模型对全身，整个髋关节，股骨颈和脊柱BMD进行评分）。我们还使用多项式研究了睡眠时间和质量与双能X线骨密度仪（DXA）定义的低骨量（T评分<-2.5至<-1）和骨质疏松症（T评分≤-2.5）的关联回归模型。我们对年龄，DXA机，种族，更年期症状，教育，吸烟，体育锻炼，体重指数，酒精使用，身体功能和睡眠药物使用情况进行了调整。在调整后的线性回归模型中，报告每晚睡眠时间不超过5小时的女性与报告每晚睡眠时间不超过7小时的女性相比，在所有四个部位的平均BMD均显着降低0.012至0.018 g / cm2。在调整后的多项式模型中，报告每晚少于5小时的女性出现低骨量和髋部骨质疏松症的几率更高（优势比[OR] = 1.22； 95％置信区间[CI] 1.03-1.45和1.63； 1.15-分别为2.31）。我们观察到了脊柱BMD的相似模式，其中每晚5小时或更短时间的女性发生骨质疏松症的几率更高（调整后的OR = 1.28； 95％CI 1.02-1.60）。睡眠质量与DXA BMD的关联未能达到统计学意义。睡眠时间短与较低的BMD和较高的骨质疏松症风险有关。需要进行纵向研究，以确认睡眠时间对骨骼健康的横断面影响，并探索相关的机制。©2019美国骨骼和矿物质研究学会。