Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
Bone. 2021 Nov;152:116096. doi: 10.1016/j.bone.2021.116096. Epub 2021 Jun 30.
Prior data demonstrated three weeks of sleep restriction and concurrent circadian disruption uncoupled bone turnover markers (BTMs), indicating decreased bone formation and no change or increased bone resorption. The effect of insufficient sleep with or without ad libitum weekend recovery sleep on BTMs is unknown.
BTMs were measured in stored serum from 20 healthy adults randomized to one of three study groups consisting of a control group (N = 3 men; 9 h/night) or one of two nocturnal sleep restriction groups in an inpatient laboratory environment. One Sleep Restriction group ("SR"; N = 9; 4 women) had 5 h sleep opportunity per night for nine nights. The other sleep restriction group had an opportunity for ad libitum Weekend Recovery sleep ("WR"; N = 8; 4 women) after four nights of 5 h sleep opportunity per night. Food intake was energy balanced at baseline and ad libitum thereafter. Fasted morning BTM levels and hourly 24 h melatonin levels were obtained on study days 3 (baseline), 5 (after 1 night of sleep restriction for WR and SR), and 11 (after a sleep restricted workweek with weekend recovery sleep in WR or 7 nights of sleep restriction in SR). Linear mixed-effects modeling was used to examine the effect of study duration (e.g., change over time), study condition, age, and sex on BTMs. Pearson correlations were used to determine associations between changes in BTMs and changes in weight and morning circadian misalignment (i.e., duration of high melatonin levels after wake time).
There was no significant difference between the three study groups in change over time (p ≥ 0.4 for interaction between assigned group and time for all BTMs), adjusted for age and sex. There was no significant change in N-terminal propeptide of procollagen type I (P1NP), osteocalcin, or C-telopeptide of type I collagen (CTX) from baseline to day 11 (all p ≥ 0.3). In women <25 years old, there was a non-significant decline in P1NP from day 3 to day 5 (= -15.74 ± 7.80 ng/mL; p = 0.06). Change in weight and morning circadian misalignment from baseline to day 11 were correlated with statistically non-significant changes in BTMs (all p ≤ 0.05).
In this small secondary analysis, we showed that nine nights of prescribed sleep restriction with or without weekend recovery sleep and ad libitum food intake did not alter BTMs. It is possible that age, sex, weight change and morning circadian misalignment modify the effects of sleep restriction on bone metabolism.
先前的数据表明，三周的睡眠限制和同时发生的昼夜节律紊乱会使骨转换标志物（BTMs）失去关联，表明骨形成减少，而骨吸收没有变化或增加。睡眠不足对 BTMs 的影响，无论是否有自由周末恢复睡眠，尚不清楚。
在 20 名健康成年人的储存血清中测量了 BTMs，这些成年人随机分为三组，一组为对照组（N=3 名男性；每晚 9 小时），另一组为两组夜间睡眠限制组之一，在住院实验室环境中进行。一组睡眠限制组（“SR”；N=9；4 名女性）每晚有 5 小时的睡眠机会，持续 9 晚。另一组睡眠限制组有机会在每晚 5 小时睡眠机会的 4 晚后进行自由周末恢复睡眠（“WR”；N=8；4 名女性）。基线和之后可以自由摄入食物。在研究日 3（基线）、5（WR 和 SR 进行第一晚睡眠限制后）和 11（WR 进行睡眠受限工作周并在周末恢复睡眠后或 SR 进行 7 晚睡眠限制后），获得禁食清晨 BTM 水平和每小时 24 小时褪黑素水平。线性混合效应模型用于检查研究时间（例如，随时间的变化）、研究条件、年龄和性别对 BTMs 的影响。Pearson 相关系数用于确定 BTMs 的变化与体重和清晨昼夜节律失调（即，唤醒后高褪黑素水平的持续时间）之间的关联。
在调整年龄和性别后，三组之间在随时间的变化方面没有显著差异（所有 BTM 的分配组和时间之间的交互作用的 p≥0.4）。从基线到第 11 天，I 型前胶原 N 端前肽（P1NP）、骨钙素或 I 型胶原 C 端肽（CTX）均无显著变化（所有 p≥0.3）。在年龄<25 岁的女性中，P1NP 从第 3 天到第 5 天有非显著下降（= -15.74±7.80ng/mL；p=0.06）。从基线到第 11 天的体重和清晨昼夜节律失调的变化与 BTMs 的统计学上无显著变化相关（所有 p≤0.05）。
在这项小型二次分析中，我们表明，九晚规定的睡眠限制，无论是否有周末恢复睡眠和自由进食，都不会改变 BTMs。年龄、性别、体重变化和清晨昼夜节律失调可能会改变睡眠限制对骨代谢的影响。
