Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany.
J Sleep Res. 2024 Feb;33(1):e14019. doi: 10.1111/jsr.14019. Epub 2023 Aug 30.
Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania-TREND underwent laboratory-based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino-terminal propeptide of type 1 procollagen (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) were measured. Cross-sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea-hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound-based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.
睡眠质量差或睡眠不足可能与骨密度降低有关。我们旨在评估睡眠特征与骨转换或骨强度之间的关联是否存在于普通人群中的成年人中，以及这些关联是否独立于常见的危险因素，如性别、年龄和肥胖。来自波美拉尼亚健康研究-TREND 的 1037 名参与者在脚跟处接受了基于实验室的多导睡眠图和定量超声测量。其中，804 名参与者完成了标准化问卷，以评估白天嗜睡、失眠和睡眠质量。测量了两种骨转换标志物的血清浓度，即 1 型胶原氨基端前肽（P1NP）和 1 型胶原羧基端肽（CTX）的完整氨基酸末端肽。在线性回归模型中评估了多导睡眠图变量（总睡眠时间、睡眠效率、睡眠起始后醒来时间、氧减饱和指数、呼吸暂停低通气指数和阻塞性睡眠呼吸暂停[OSA]）以及睡眠问卷评分与骨转换标志物和基于超声的硬度指数之间的横断面关联。在调整后的模型中，较高的失眠评分和较低的睡眠质量评分与女性的骨转换率较高相关，但与男性无关。然而，多导睡眠图变量或问卷评分与硬度指数之间没有关联。我们的研究提供了有限的证据，表明睡眠特征与骨转换和骨强度之间存在独立于 OSA 和骨质疏松症常见危险因素的关系。尽管如此，报告睡眠不佳或失眠并伴有骨质疏松症危险因素的女性可能需要评估骨骼健康。
