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Zhao H, Jia H, Jiang Y, Suo C, Liu Z, Chen X, Xu K. Associations of sleep behaviors and genetic risk with risk of incident osteoporosis: A prospective cohort study of 293,164 participants. Bone 2024; 186:117168. [PMID: 38878990 DOI: 10.1016/j.bone.2024.117168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/28/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Unhealthy sleep behaviors are associated with higher risks of osteoporosis (OP), while prospective evidence is limited. This study aimed to prospectively investigate this association, quantify the attributable burden of OP incidence reduction due to unhealthy sleep behaviors, and explore potential modifications by genetic risk factors. METHODS This longitudinal cohort study was conducted utilizing data from the UK Biobank, comprising 293,164 participants initially free of OP and with requisite sleep behaviors data at baseline. We followed the participants after recruitment until November 30, 2022, to ascertain incident OP. We assessed the associations of five sleep behaviors including sleep duration, chronotype, insomnia, daytime napping, and morning wake-up difficulties, as well as sleep behavior patterns identified based on the above sleep behaviors, with the risk of OP, using Cox models adjusted for multiple confounders. The analyses were then performed separately among individuals with different OP susceptibility, indexed by standard polygenetic risk scores(PRS) for OP. Our secondary outcome was OP with pathologic fracture. Subgroup and sensitivity analyses were performed. Additionally, attributable risk percent in the exposed population (AR%) and population attributable fraction (PAF) of sleep behaviors were calculated. RESULTS Over a median follow-up of 13.7 years, 8253 new-onset OP cases were documented. Unhealthy sleep behaviors, such as long or short sleep duration, insomnia, daytime napping, morning wake-up difficulties, and unhealthy sleep patterns, were associated with elevated risks of OP (HRs ranging from 1.14 to 1.46, all P-value <0.001) compared to healthy sleep behaviors. Similar associations were observed for OP with pathologic fractures. Insomnia exhibited the largest AR% of 39.98 % (95%CI: 36.46, 43.31) and PAF of 33.25 % (95%CI: 30.00, 36.34) among healthy sleep patterns and components. A statistically significant multiplicative interaction was noted between sleep behaviors and OP PRS on OP risk (all P-interaction <0.001). CONCLUSIONS Four unhealthy sleep behaviors and sleep behavior patterns were associated to increased OP risk, with insomnia contributing the most to OP incidence, while genetic risk for OP modified this association. These findings underscore the crucial role of adhering to healthy sleep behaviors for effective OP prevention.
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Affiliation(s)
- Hanhan Zhao
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Hongyu Jia
- Wuyang Disease Control and Prevention Center, Luohe, Henan, China
| | - Yanfeng Jiang
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Chen Suo
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Zhenqiu Liu
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Xingdong Chen
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
| | - Kelin Xu
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
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Pitts S. Bone Health: A Review. Pediatr Rev 2024; 45:440-449. [PMID: 39085182 DOI: 10.1542/pir.2023-006167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Sarah Pitts
- Division of Adolescent/Young Adult Medicine and Division of Endocrinology, Boston Children's Hospital, and Harvard Medical School, Boston, MA
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Meneses-León J, Hernández-Salazar S, Robles-Rivera K, Tamayo-Ortiz M, Muciño-Sandoval K, Rivas-Ruiz R, Denova-Gutiérrez E, Tamayo-Orozco JA, Velázquez-Cruz R, Salmerón J, Rivera-Paredez B. Association Between Changes in Sleep, Nap Duration and Bone Mineral Density in Mexican Adults. Calcif Tissue Int 2024; 115:31-40. [PMID: 38758431 PMCID: PMC11153263 DOI: 10.1007/s00223-024-01224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 05/18/2024]
Abstract
Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD has not been explored. We evaluated the association between the change in sleep and nap duration and BMD in Mexican adults. Data come from 1,337 adult participants of the Health Workers Cohort Study (341 were men and 996 were women, including 450 women < 45 years old and 546 ≥ 45 years old), with two study waves. At each wave, sleep and nap duration was assessed using self-administered questionnaires and BMD in g/cm2 was determined by dual X-ray absorptiometry. We used fixed-effect regression models stratified by sex and adjusted for BMI, diet, physical activity, vitamin supplements, and hormone replacement therapy. Women who changed from < 7 to ≥ 7 h/day of sleep from baseline to follow-up were associated with increases in the total hip (β = 0.012 g/cm2; 95% CI: 0.002, 0.022) and lumbar spine BMD (β = 0.024 g/cm2; 95% CI: 0.009, 0.039). Furthermore, most of these associations were observed in women ≥ 45 years. For women, a changing from 0 to > 60 min/day of napping was associated with a significant increase in total hip BMD of 0.012 g/cm2 (95% CI: 0.004, 0.024) and lumbar spine BMD of 0.027 g/cm2 (95% CI: 0.009, 0.045). No significant associations were observed for men. Our results suggest that increased sleep and nap duration are associated with gains in BMD in Mexican women, emphasizing sleep's role in promoting bone health and supporting established recommendations.
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Affiliation(s)
- Joacim Meneses-León
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Zona Cultural S/N, CIPPS 2° Piso Ciudad Universitaria, Coyoacán, C.P., 04510, Mexico City, Mexico
| | - Sonia Hernández-Salazar
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Zona Cultural S/N, CIPPS 2° Piso Ciudad Universitaria, Coyoacán, C.P., 04510, Mexico City, Mexico
| | - Karina Robles-Rivera
- Secretary of Clinical Teaching, Medical Internship, and Social Service, School of Medicine, UNAM. Circuito Interior, Ciudad Universitaria, Avenida Universidad 3000, C.P., 04510, Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Karla Muciño-Sandoval
- Accessalud, Av. Insurgentes Sur 299, Hipódromo, Cuauhtémoc, C.P., 06100, Mexico City, México
| | - Rodolfo Rivas-Ruiz
- Training and Clinical Research Center, Health Research Coordination. Mexican Social Security Institute (IMSS), Av. Cuauhtémoc #330, Col. Doctores, C.P., 06720, Mexico City, Mexico
| | - Edgar Denova-Gutiérrez
- Center for Research in Nutrition and Health, National Institute of Public Health (INSP), Mexico. Av. Universidad #655, Col. Santa María Ahuacatitlán. C.P., 62100, Cuernavaca, Morelos, Mexico
| | - Juan A Tamayo-Orozco
- Accessalud, Av. Insurgentes Sur 299, Hipódromo, Cuauhtémoc, C.P., 06100, Mexico City, México
| | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Periférico Sur No. 4809, Col. Arenal Tepepan, Alcaldía Tlalpan, C.P., 14610, Mexico City, Mexico
| | - Jorge Salmerón
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Zona Cultural S/N, CIPPS 2° Piso Ciudad Universitaria, Coyoacán, C.P., 04510, Mexico City, Mexico
| | - Berenice Rivera-Paredez
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Zona Cultural S/N, CIPPS 2° Piso Ciudad Universitaria, Coyoacán, C.P., 04510, Mexico City, Mexico.
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Wu L, Han S, Cui B, Wang C, Zhang Z, Chen Z. Analysis of the relationship between shorter sleep duration and wrist fractures: based on NHANES. BMC Musculoskelet Disord 2024; 25:378. [PMID: 38745283 PMCID: PMC11092176 DOI: 10.1186/s12891-024-07497-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Wrist fracture is one of the common limb fractures. Its incidence rate increases with age and osteoporosis. Nowadays, Sleep health is increasingly valued, but the relationship between wrist fractures and sleep time is not yet clear. METHODS Data in this study were collected and screened from the NHANES from 2005 to 2010 and 2013 to 2014. The variables were extracted from interviews and compared between the wrist fractures and the sleep duration. The data was analyzed by weighted multivariate logistic regression. RESULTS After excluding individuals who were not eligible and had invalid data, we finally identified 1835 participants for inclusion in this study. We found a negative association between the sleep duration and the fractured of the wrist (OR = 1.027,95% CI (1.027, 1.028), P < 0.00001). CONCLUSION This study demons that the association between the sleep duration and the fractures of the wrist is significant. Our findings provide a better understanding of the relationship between sleep duration and wrist fractures. This study may help us reducing the incidence of wrist fractures in the population based on healthy sleep management in the future, and improve the quality of life of middle-aged and elderly patients. Provide evidence for clinical patients to manage healthy sleep.
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Affiliation(s)
- Lang Wu
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China
| | - Shaoyu Han
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China
| | - Bingjun Cui
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China
| | - Chuangong Wang
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China
| | - Zhenqing Zhang
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China
| | - Zhixiang Chen
- Trauma Center, Huai'an Hospital Affiliated to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, 223001, China.
- Department of Orthopedic Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu Province, 225001, China.
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Al-Ansari N, Samuel SM, Büsselberg D. Unveiling the Protective Role of Melatonin in Osteosarcoma: Current Knowledge and Limitations. Biomolecules 2024; 14:145. [PMID: 38397382 PMCID: PMC10886489 DOI: 10.3390/biom14020145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024] Open
Abstract
Melatonin, an endogenous neurohormone produced by the pineal gland, has received increased interest due to its potential anti-cancer properties. Apart from its well-known role in the sleep-wake cycle, extensive scientific evidence has shown its role in various physiological and pathological processes, such as inflammation. Additionally, melatonin has demonstrated promising potential as an anti-cancer agent as its function includes inhibition of tumorigenesis, induction of apoptosis, and regulation of anti-tumor immune response. Although a precise pathophysiological mechanism is yet to be established, several pathways related to the regulation of cell cycle progression, DNA repair mechanisms, and antioxidant activity have been implicated in the anti-neoplastic potential of melatonin. In the current manuscript, we focus on the potential anti-cancer properties of melatonin and its use in treating and managing pediatric osteosarcoma. This aggressive bone tumor primarily affects children and adolescents and is treated mainly by surgical and radio-oncological interventions, which has improved survival rates among affected individuals. Significant disadvantages to these interventions include disease recurrence, therapy-related toxicity, and severe/debilitating side effects that the patients have to endure, significantly affecting their quality of life. Melatonin has therapeutic effects when used for treating osteosarcoma, attributed to its ability to halt cancer cell proliferation and trigger apoptotic cell death, thereby enhancing chemotherapeutic efficacy. Furthermore, the antioxidative function of melatonin alleviates harmful side effects of chemotherapy-induced oxidative damage, aiding in decreasing therapeutic toxicities. The review concisely explains the many mechanisms by which melatonin targets osteosarcoma, as evidenced by significant results from several in vitro and animal models. Nevertheless, if further explored, human trials remain a challenge that could shed light and support its utility as an adjunctive therapeutic modality for treating osteosarcoma.
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Affiliation(s)
- Nojoud Al-Ansari
- Department of Medical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar;
| | - Samson Mathews Samuel
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | - Dietrich Büsselberg
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
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Zhou T, Dai X, Yuan Y, Xue Q, Li X, Wang M, Ma H, Heianza Y, Qi L. Adherence to a healthy sleep pattern is associated with lower risks of incident falls and fractures during aging. Front Immunol 2023; 14:1234102. [PMID: 37662961 PMCID: PMC10470625 DOI: 10.3389/fimmu.2023.1234102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Background Autoimmune diseases are more common among people with unhealthy sleep behaviors, and these conditions have been linked to aging-related bone health. However, there have been few studies that examined the correlation between recently developed sleep patterns based on sleep duration, sleepiness, chronotype, snoring, insomnia, and the incidence of falls and fractures. Methods We used a newly developed sleep pattern with components of sleep 7 to 8 h per day, absence of frequent excessive daytime sleepiness, early chronotype, no snoring, and no frequent insomnia as healthy factors to study their relationship with the incidence of falls and fractures. The analysis was conducted among 289,000 participants from the UK Biobank. Results The mean follow-up period was 12.3 years (3.5 million person-years of follow-up), and 12,967 cases of falls and 16,121 cases of all fractures were documented. Compared to participants exhibiting an unfavorable sleep pattern, those adhering to a healthy sleep pattern experienced a 17% and 28% reduction in the risks of incident falls (hazard ratio [HR], 0.83; 95% CI, 0.74-0.93) and all fractures (HR, 0.72; 95% CI, 0.66-0.79) during follow-up. In addition, participants exhibiting a healthy sleep pattern, together with a high genetically determined bone mineral density (BMD), showed the lowest risks of falls and fractures. Conclusion A healthy sleep pattern was significantly linked to decreased risks of incident falls and fractures. The protective association was not modified by genetically determined BMD.
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Affiliation(s)
- Tao Zhou
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Xue Dai
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiaochu Xue
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Mengying Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Yin WJ, Yu LJ, Wang P, Tao RX, Jiang XM, Zhang Y, Zhu DM, Zhu P. Sleep patterns modify the association of 25(OH)D with poor cardiovascular health in pregnant women. Front Nutr 2022; 9:1013960. [PMID: 36451743 PMCID: PMC9702519 DOI: 10.3389/fnut.2022.1013960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The relationship between vitamin D status and gestational cardiovascular health (CVH) is inconsistent in previous studies. Emerging evidence shows that sleep behaviors are related to vitamin D metabolism. However, no studies evaluate the interaction of vitamin D and sleep behaviors on gestational CVH. OBJECTIVE We aimed to estimate the relationship between 25-hydroxyvitamin D [25(OH)D] concentrations and gestational CVH, and whether the relationship was modified by sleep behaviors. METHODS The data of this study was from a multicenter birth cohort study. A total of 9,209 pregnant women at 16-23 weeks of gestation were included. 25(OH)D concentrations were measured from collected blood. Sleep patterns consisted of major sleep behaviors including duration, chronotype, insomnia, snoring, and excessive daytime sleepiness. Data on poor CVH was based on four "clinical" CVH metrics, including body mass index, blood pressure, total cholesterol, and glucose levels. RESULTS The proportion of women with poor CVH was 25.0%. The relative risk (RR) (95%CI) of poor CVH was 0.67 (0.58-0.76) in women with 25(OH)D ≥ 50 nmol/L after multivariate adjustments. Lower 25(OH)D concentrations were significantly associated with poor CVH. Such association was also evident in subgroups analysis. We found a significant interaction of 25(OH)D (P for interaction = 0.01) with sleep patterns on the risk of poor CVH. A negative dose-response relation was observed between 25(OH)D concentrations and poor CVH risk in healthy or intermediate sleep, not poor sleep. 25(OH)D concentrations were lower and the risk of poor CVH was higher in pregnant women with poor sleep patterns (P < 0.05). CONCLUSION Our study suggests that sleep patterns modify the association of 25(OH)D concentrations with the CVH among pregnant women.
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Affiliation(s)
- Wan-jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Li-jun Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-xue Tao
- Department of Obstetrics and Gynecology, Hefei First People’s Hospital, Hefei, China
| | - Xiao-min Jiang
- Department of Obstetrics and Gynecology, Anhui Province Maternity and Child Health Hospital, Hefei, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dao-min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Swanson CM, Shanbhag P, Tussey EJ, Rynders CA, Wright KP, Kohrt WM. Bone Turnover Markers After Six Nights of Insufficient Sleep and Subsequent Recovery Sleep in Healthy Men. Calcif Tissue Int 2022; 110:712-722. [PMID: 35133471 PMCID: PMC9117441 DOI: 10.1007/s00223-022-00950-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/22/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal of this study was to determine the bone turnover marker (BTM) response to insufficient and subsequent recovery sleep, independent of changes in posture, body weight, and physical activity. METHODS Healthy men (N = 12) who habitually slept 7-9 h/night were admitted to an inpatient sleep laboratory for a baseline 8 h/night sleep opportunity followed by six nights of insufficient sleep (5 h/night). Diet, physical activity, and posture were controlled. Serum markers of bone formation (osteocalcin, PINP) and resorption (β-CTX) were obtained over 24 h at baseline and on the last night of sleep restriction, and on fasted samples obtained daily while inpatient and five times after discharge over 3 weeks. Maximum likelihood estimates in a repeated measures model were used to assess the effect of insufficient and subsequent recovery sleep on BTM levels. RESULTS There was no statistically or clinically significant change in PINP (p = 0.53), osteocalcin (p = 0.66), or β-CTX (p = 0.10) in response to six nights of insufficient sleep. There were no significant changes in BTMs from the inpatient stay through 3 weeks of recovery sleep (all p [Formula: see text] 0.63). On average, body weight was stable during the inpatient stay (Δweight = - 0.55 ± 0.91 kg, p = 0.06). CONCLUSION No significant changes in serum BTMs were observed after six nights of insufficient or subsequent recovery sleep in young healthy men. Changes in weight and physical activity may be required to observe significant BTM change in response to sleep and circadian disruptions. Clinical Trials Registration Registered at ClinicalTrials.gov (NCT03733483) on November 7, 2018.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave, Mail Stop 8106, Aurora, CO, 80045, USA.
| | - Prajakta Shanbhag
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - Emma J Tussey
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - Corey A Rynders
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave, Mail Stop 8106, Aurora, CO, 80045, USA
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
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Abstract
PURPOSE OF REVIEW Review recent literature investigating the relationship between bone health and sleep/circadian disruptions (e.g., abnormal sleep duration, night shift work). RECENT FINDINGS Short and long sleep are associated with low bone mineral density (BMD). Recent data from observational studies identified an increased risk of fracture in women with short sleep. Studies suggest that age, sex, weight change, and concurrent circadian misalignment may modify the effects of sleep restriction on bone metabolism. Interventional studies demonstrate alterations in bone metabolism and structure in response to circadian disruption that could underlie the increased fracture risk seen with night shift work. The effects of sleep and circadian disruption during adolescence may have lifelong skeletal consequences if they adversely impact bone modeling. Data suggest that short sleep and night shift work negatively impact bone metabolism and health. Rigorous studies of prevalent sleep and circadian disruptions are needed to determine mechanisms and develop prevention strategies to optimize lifelong skeletal health.
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Affiliation(s)
- Christine Swanson
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave., Mail Stop 8106, Aurora, CO, 80045, USA.
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Cheah JW, Freshman RD, Mah CD, Kinjo S, Lansdown DA, Feeley BT, Zhang AL, Ma CB. Orthopedic sleep and novel analgesia pathway: a prospective randomized controlled trial to advance recovery after shoulder arthroplasty. J Shoulder Elbow Surg 2022; 31:S143-S151. [PMID: 35413431 DOI: 10.1016/j.jse.2022.02.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Lack of sleep is associated with adverse effects on postsurgical pain and recovery. We hypothesized that a multimodal sleep pathway, including nonpharmacologic sleep hygiene interventions and the use of zolpidem and melatonin, could improve patient analgesia and sleep after total shoulder arthroplasty. METHODS We performed a prospective randomized controlled study in which patients undergoing anatomic and reverse total shoulder arthroplasty were treated with or without an interventional multimodal sleep pathway. This pathway included nursing-directed nonpharmacologic measures that promote sleep hygiene and pharmacologic interventions with low-dose zolpidem and melatonin at bedtime. All patients underwent a standardized multimodal analgesia protocol with scheduled acetaminophen, naproxen, and gabapentin, as well as a single-shot interscalene regional nerve block. RESULTS This study enrolled 125 patients (64 in control group and 61 in interventional group) with similar demographic characteristics. The interventional group showed less oral morphine milligram equivalent (MME) consumption on postoperative day (POD) 0 (44.8 ± 36.1 MMEs vs. 60.9 ± 42.1 MMEs, P = .01) and showed a trend toward lower POD 0 visual analog scale pain scores (2.6 ± 1.8 vs. 3.3 ± 3.0, P = .06). Visual analog scale pain scores and MME consumption were similar on POD 1. The interventional group showed a longer objective sleep duration by quantitative wrist actigraphy (5.9 ± 3.1 hours vs. 4.6 ± 2.7 hours, P = .008), with better sleep quality assessed by the Leeds Sleep Evaluation Questionnaire (0-100 scale; 50.3 ± 26.8 vs. 38.5 ± 27.8, P = .01). The 2 groups showed similar satisfaction with pain management (89.2% vs. 79.6%, P = .16) and sleep management (82.1% vs. 76.8%, P = .48). There was no difference in the length of inpatient stay (32.2 ± 14.8 hours vs. 34.1 ± 12.8 hours, P = .44). CONCLUSION In the setting of a regional and multimodal analgesia recovery plan for shoulder arthroplasty patients undergoing inpatient observation, the use of an interventional sleep pathway appears to be safe and beneficial, with improved analgesia, reduced opioid use, increased sleep duration, and improved reported sleep quality during the postoperative recovery period.
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Affiliation(s)
- Jonathan W Cheah
- Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA, USA; Stanford University, Palo Alto, CA, USA.
| | - Ryan D Freshman
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Cheri D Mah
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Sakura Kinjo
- Department of Anesthesiology and Perioperative Care, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Drew A Lansdown
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Alan L Zhang
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - C Benjamin Ma
- Department of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA, USA
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11
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Chen P, Wu H, Yao H, Zhang J, Fan W, Chen Z, Su W, Wang Y, Li P. Multi-Omics Analysis Reveals the Systematic Relationship Between Oral Homeostasis and Chronic Sleep Deprivation in Rats. Front Immunol 2022; 13:847132. [PMID: 35432311 PMCID: PMC9009293 DOI: 10.3389/fimmu.2022.847132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep disorders were associated with oral health. Inflammation has especially been thought to be a key factor in linking oral diseases and sleep deficiency. However, how chronic sleep deprivation (CSD) affects oral homeostasis, particularly oral inflammation and oral microbiota, is still unknown. This study aimed to uncover the systematic relationship between oral homeostasis and CSD in rats. The metabolomics in serum, proteomics in the tongue tissues, and microbiome analysis in the oral cavity in CSD rats were performed. Multi-omics data integration analysis was performed to uncover the systematic relationship between oral homeostasis and CSD through the weighted correlation network analysis. We found that CSD could lead to oral inflammation in rats. CSD significantly increased systemic inflammation by enhancing the serum levels of IL-1β, IL-6 and inhibiting the serum level of IL-10. Serum levels of adrenocorticotropin hormone, corticosterone, and triiodothyronine were increased in CSD rats, and the steroid hormone biosynthesis pathway was also found to be involved in the perturbation resulting from CSD, together suggesting the activation of the hypothalamic-pituitary-adrenocortical and hypothalamic‐pituitary‐thyroid axis. CSD led to changes of oral microbiota composition, and g_Acinetobacter, Candidatus Chryseobacterium massiliae, and g_Moraxella were significantly correlated with multiple proteins in bacterial invasion of epithelial cells pathway, which may partially responsible for oral inflammation resulting from CSD. The changes of proteomic profiling expression caused by CSD in tongue tissues were mainly enriched in neurodegenerative diseases pathways and immune/inflammation-related pathways. Multi-omics analysis indicated that the inflammatory response-related modules were significantly correlated with the neurodegenerative disease-related module suggesting a possible link between neurodegenerative diseases and oral inflammation. Together, CSD induced oral inflammation and subtle changes on oral microbiota. Our study is helpful to further understand the role that oral homeostasis plays in the process by which CSD affects human health and disease.
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Affiliation(s)
- Pan Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Hao Wu
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Hongliang Yao
- Guangdong Key Laboratory of Animal Conservation and Resource Utilization, Guangdong Public Laboratory of Wild Animal Conservation and Utilization, Institute of Zoology, Guangdong Academy of Sciences, Guangzhou, China
| | - Jiashuo Zhang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Weiyang Fan
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Zhen Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Weiwei Su
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yonggang Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Peibo Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed Traditional Chinese Medicine (TCM), State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
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12
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Cheah JW, Danilkowicz R, Hutyra C, Lewis B, Olson S, Poehlein E, Green CL, Mather R. High Prevalence of Sleep Disturbance Is Associated with Femoroacetabular Impingement Syndrome. Arthrosc Sports Med Rehabil 2022; 4:e495-e501. [PMID: 35494310 PMCID: PMC9042751 DOI: 10.1016/j.asmr.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 11/01/2021] [Indexed: 10/24/2022] Open
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13
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Duan X, Pan Q, Guo L. Chronic Sleep Deprivation Impaired Bone Formation in Growing Rats and Down-Regulated PI3K/AKT Signaling in Bone Tissues. Nat Sci Sleep 2022; 14:697-710. [PMID: 35444481 PMCID: PMC9015811 DOI: 10.2147/nss.s351850] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to assess the effects of chronic sleep deprivation (CSD) on bone metabolism in growing rats and the likely underlying mechanism. METHODS Twenty 5-week-old male Wistar rats and randomly divided into the CSD and normal control (NC) groups after one-week acclimatization. After a 6-week intervention of sleep deprivation, the distal femurs of both groups were harvested for micro-computed tomography scans and histological analysis. Meanwhile, the femur tissues were measured the mRNA and protein expression via RNA sequencing and immunohistochemical analysis. Serum bone turnover markers were evaluated at 0, 2, 4, and 6 weeks. RESULTS CSD impaired the bone growth, showing an imbalance of bone turnover status, dysphasia in the metaphysis growth plate, and deterioration of bone microarchitecture. Further, CSD suppressed bone formation, showing that the expression of osteogenesis-related proteins (col1α1 and osteocalcin) and mRNA (igf1, bglap, runx2, col1α1, pth1r) are down-regulated. Differentially expressed genes were detected, and functional enrichment analyses revealed that the PI3K/AKT pathway was significantly down-regulated in the CSD group. CONCLUSION These results suggest that CSD can significantly impaire bone health, and it may exert these effects in part by suppressing bone formation and osteoblast differentiation, and inactivating the PI3K/AKT signaling pathway.
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Affiliation(s)
- Xiaoye Duan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Qi Pan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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14
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Beetz G, Herrero Babiloni A, Jodoin M, Charlebois-Plante C, Lavigne GJ, De Beaumont L, Rouleau DM. Relevance of Sleep Disturbances to Orthopaedic Surgery: A Current Concepts Narrative and Practical Review. J Bone Joint Surg Am 2021; 103:2045-2056. [PMID: 34478407 DOI: 10.2106/jbjs.21.00176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Sleep disturbances can increase the risk of falls and motor vehicle accidents and may reduce bone density. ➤ Poor sleep can lead to worse outcomes after fracture, such as chronic pain and delayed recovery. ➤ Orthopaedic surgeons can play an important role in the screening of sleep disorders among their patients.
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Affiliation(s)
- Gabrielle Beetz
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Alberto Herrero Babiloni
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Marianne Jodoin
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | | | - Gilles J Lavigne
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada.,Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Louis De Beaumont
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Department of Surgery, University of Montreal, Montreal, Quebec, Canada
| | - Dominique M Rouleau
- Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Department of Surgery, University of Montreal, Montreal, Quebec, Canada
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15
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Chen J, Zhang J, So HC, Ai S, Wang N, Tan X, Wing YK. Association of Sleep Traits and Heel Bone Mineral Density: Observational and Mendelian Randomization Studies. J Bone Miner Res 2021; 36:2184-2192. [PMID: 34184784 DOI: 10.1002/jbmr.4406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/21/2021] [Accepted: 06/22/2021] [Indexed: 12/16/2022]
Abstract
Observational studies have suggested that sleep and circadian disturbances are potentially modifiable risk factors for low bone mineral density (BMD), but the causal relationship is unclear. This study aimed to (i) replicate the findings by examining observational association of sleep traits with low estimated BMD); (ii) examine whether these associations were causal by using Mendelian randomization (MR) analyses; and (iii) investigate potential modulation effects of sex and menopause. A total of 398,137 White British subjects (aged 39 to 73 years) with valid BMD estimated by quantitative ultrasound of the heel (eBMD) at baseline were included. Linear regression analyses and inverse-variance weighted method were used as main methods for observational and one-sample MR analyses, respectively, to investigate the associations between self-reported sleep traits (sleep duration, chronotype, daytime sleepiness, and insomnia) and low eBMD. Furthermore, sensitivity analyses were performed in subgroups based on sex and menopause in both observational and MR analyses. In observational analyses, short/long sleep, insomnia, and definite eveningness were associated with low eBMD (short sleep: β = -0.045, effect in standard deviation change of rank-based inverse normally transformed eBMD; long sleep: β = -0.028; sometimes insomnia: β = -0.012; usually insomnia: β = -0.021; definite eveningness: β = -0.047), whereas definite morningness was associated with decreased risk of low eBMD (β = 0.011). Subgroup analyses suggested associations of short/long sleep and definite eveningness with low eBMD among men, short sleep with low eBMD among premenopausal women, and short sleep, eveningness, and daytime sleepiness among postmenopausal women. In bidirectional MR analyses, there was no causal relationship between sleep traits and eBMD in either overall sample or subgroup analyses. In summary, although observational analysis showed a robust association of low eBMD with sleep duration, chronotype, and insomnia, there was no evidence of causal relationship as suggested by MR analysis. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Jie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Hon Cheong So
- School of Biomedical Sciences, Department of Psychiatry, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Cheung Research Centre for Management of Parkinsonism, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Sizhi Ai
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiao Tan
- Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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16
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Depner CM, Rice JD, Tussey EJ, Eckel RH, Bergman BC, Higgins JA, Melanson EL, Kohrt WM, Wright KP, Swanson CM. Bone turnover marker responses to sleep restriction and weekend recovery sleep. Bone 2021; 152:116096. [PMID: 34216838 PMCID: PMC8316414 DOI: 10.1016/j.bone.2021.116096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/28/2021] [Accepted: 06/25/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND 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. METHODS 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). RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Christopher M Depner
- 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
| | - John D Rice
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Emma J Tussey
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bryan C Bergman
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Janine A Higgins
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA; Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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17
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Association of short sleep duration and trabecular bone score. Sci Rep 2021; 11:19821. [PMID: 34615958 PMCID: PMC8494739 DOI: 10.1038/s41598-021-99410-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
Short sleep duration has been found to be associated with bone health deterioration by using bone mineral density (BMD). Only a few attempts have been made to assess the association of sleep duration and bone by utilizing the trabecular bone score (TBS). The aim of this study was to examine the association between sleep duration and TBS from a national database. A total of 4480 eligible participants older than 20 years who attended the United States National Health and Nutrition Examination Survey (NHANES) from 2005 to 2006 with TBS data and self-reported sleep duration. The association between sleep duration and TBS was investigated using a multivariate regression model with covariate adjustment. TBS was lowest in individuals with a short sleep duration (≤ 5 h) and it was increased in those with longer self-reported total sleep times. After a full adjustment for covariates, those sleeping less than 5 h had a significantly lower TBS than the reference group (sleep duration of 7 h). In subgroup analyses, an association between short sleep duration (≤ 5 h) and lower TBS persisted in older ages (≥ 60 years old), women, obese adults (BMI ≥ 30 kg/m2), and non-Hispanic Whites. Short sleep duration is associated with low TBS in women, obese adults (BMI ≥ 30 kg/m2), and non-Hispanic whites. Strict self-monitoring of body weight, well-tailored controls of underlying disease(s), and adequate sleep may help prevent osteoporosis.
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18
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Bartholomew J, Gilligan C, Spence A. Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts. SPORTS MEDICINE - OPEN 2021; 7:57. [PMID: 34373962 PMCID: PMC8353044 DOI: 10.1186/s40798-021-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022]
Abstract
The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts. The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.
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Affiliation(s)
- Janine Bartholomew
- Department of Biology, Portage Learning, 2521 Darlington Road, Beaver Falls, PA, 15010, USA
| | - Carrie Gilligan
- Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA
| | - Ann Spence
- Department of Nursing, Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA.
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19
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Swanson CM, Blatchford PJ, Stone KL, Cauley JA, Lane NE, Rogers-Soeder TS, Redline S, Bauer DC, Wright KP, Wierman ME, Kohrt WM, Orwoll ES. Sleep duration and bone health measures in older men. Osteoporos Int 2021; 32:515-527. [PMID: 32930851 PMCID: PMC7933119 DOI: 10.1007/s00198-020-05619-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/01/2020] [Indexed: 01/11/2023]
Abstract
UNLABELLED The associations between objective measures of sleep duration and bone outcomes in older men are unknown. No consistent, significant association was identified between sleep duration and bone mineral density (BMD) in the current analysis. However, future research should determine if vitamin D status modifies this relationship. INTRODUCTION Prior studies, predominantly in women, reported that long and short self-reported sleep duration are associated with lower BMD. Associations between actigraphy-determined sleep duration and BMD or bone turnover markers (BTMs) in older men are unknown. METHODS Men in The Osteoporotic Fractures in Men (MrOS) Study with wrist actigraphy and concurrent BMD assessment but without comorbidities affecting bone health were included. Sleep duration was considered as a continuous (N = 1926) and dichotomized variable where men were classified as getting the recommended (7-8 h/night; N = 478) or short (< 6 h/night; N = 577) sleep. The cross-sectional association between BMD, BTMs, and sleep duration was examined using a t test or linear regression, where appropriate, in unadjusted and adjusted models. RESULTS There were no clinically or statistically significant differences in BMD at the L-spine, total hip, or femoral neck between men getting the recommended vs. short sleep duration, using actigraphy or self-reported sleep duration (all p ≥ 0.07). When sleep duration was considered as a continuous variable, femoral neck BMD was higher in men with longer self-reported sleep duration (β = 0.006 ±0.003, p = 0.02), but this was not significant after further adjustment. In men with low 25OHD (< 20 ng/mL), longer actigraphy-determined sleep duration was associated with higher total hip BMD (β = 0.016 ± 0.008; p = 0.04). Sleep duration and BTMs were not associated. CONCLUSION Sleep duration was not associated with hip or L-spine BMD or BTMs in older men. Future research should determine if vitamin D status or other factors modify this relationship.
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Affiliation(s)
- C M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA.
| | - P J Blatchford
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - K L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - N E Lane
- Center for Musculoskeletal Health, University of California, Davis Health, Davis, CA, USA
| | | | - S Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - D C Bauer
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
- University of California San Francisco Medical Center, San Francisco, CO, USA
| | - K P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - M E Wierman
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - W M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - E S Orwoll
- Division of Endocrinology and Bone & Mineral Unit, Oregon Health & Science University, Portland, OR, USA
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Vitamin D and sleep duration: Is there a bidirectional relationship? Horm Mol Biol Clin Investig 2020; 41:/j/hmbci.ahead-of-print/hmbci-2020-0025/hmbci-2020-0025.xml. [DOI: 10.1515/hmbci-2020-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 10/26/2020] [Indexed: 11/15/2022]
Abstract
Abstract
Vitamin D contributes to numerous physiological processes within the body but primarily calcium and bone homeostasis. Emerging evidence highlights a novel role for vitamin D in maintaining and regulating optimal sleep. Sleep is a known regulator of bone health, highlighting the interconnectedness between vitamin D concentrations, sleep duration and bone metabolism. It is possible that the relationship between sleep length and vitamin D is bidirectional, with vitamin D playing a role in sleep health and conversely, sleep affecting vitamin D levels. Nevertheless, limited information on the direction of the interaction is available, and much remains to be learned concerning the complex relationship between insufficient sleep duration and vitamin D deficiency. Given the potential to implement interventions to improve sleep and vitamin D supplementation, understanding this relationship further could represent a novel way to support and improve health.
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XIONG M, LIU X, YOU L, CHEN X. [Relationship between sleep quality and bone mineral density in urban residents]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2020; 49:431-438. [PMID: 32985155 PMCID: PMC8800768 DOI: 10.3785/j.issn.1008-9292.2020.08.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the relationship between sleep quality and bone mineral density (BMD) in urban residents. METHODS Data of 28 756 Han adults (14 355 males and 14 401 females), who completed both Pittsburgh sleep quality index (PSQI) assessment and radial BMD tests by dual energy X-ray absorptiometry in the Health Management Center of Southwest China University from June 2012 to June 2019 were retrospectively analyzed. The degree of sleep disorder was determined based on PSQI scores, while osteopenia and osteoporosis was diagnosed according to BMD T-value. The χ2 test and multiple regression model were used to investigate the relationship between sleep quality and BMD. RESULTS The numbers of normal BMD, osteoponia and osteoporosis were 17 039 (59.3%), 7916(27.5%) and 3801(13.2%), respectively. The mean PSQI score was 5.6±1.4 points. According to PSQI scores, there were 15 936 subjects without sleep disorder (55.4%), 5965 with mild (20.7%), 4897 with moderate (17.0%) and 1958 with severe sleep disorder (6.8%), respectively. There was no significant difference in osteoponia/osteoporosis rate between subjects with mild sleep disorder and normal ones (χ2=0.948, P>0.05), while the rate of osteoporosis in moderate sleep disorder group was higher than that in mild group (χ2=525.583, P<0.01), and the rate of osteoponia/osteoporosis in severe sleep disorder group was much higher than that in moderate group (χ2=1124.877, P<0.01). Multiple regression results showed that female, elders, mental labor, smoking and higher PSQI scores were independently associated with lower T-value (all P<0.05), while moderate to intense daily physical activity was associated with higher T-value (P<0.05). CONCLUSIONS Sleep disturbances may be a major risk factor for BMD loss in urban residents, indicating that it would be a potential target of osteoporosis prevention.
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Affiliation(s)
| | - Xiang LIU
- 刘翔(1980-), 男, 学士, 主治医师, 主要从事社区常见慢性病防治、临床内科学、健康教育及健康促进研究; E-mail:
;
https://orcid.org/0000-0003-3971-218X
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Swanson CM, Shea SA, Kohrt WM, Wright KP, Cain SW, Munch M, Vujović N, Czeisler CA, Orwoll ES, Buxton OM. Sleep Restriction With Circadian Disruption Negatively Alter Bone Turnover Markers in Women. J Clin Endocrinol Metab 2020; 105:5828773. [PMID: 32364602 PMCID: PMC7448297 DOI: 10.1210/clinem/dgaa232] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of this work is to determine whether an uncoupling of bone turnover markers (BTMs) occurs in women exposed to the combination of sleep restriction with circadian disruption (SRCD), as previously reported in men. METHODS Four bone biomarkers (N-terminal propeptide of type I procollagen [P1NP] and osteocalcin = bone formation; C-telopeptide [CTX] = bone resorption; sclerostin = bone formation inhibitor) were measured in bihourly samples over 24 hours at baseline and after approximately 3 weeks of sleep restriction (~5.6 hours of sleep/24 hours) with concurrent circadian disruption (SRCD, recurring 28-hour "day" in dim light). Maximum likelihood estimation in a repeated-measures model was used to assess the effects of SRCD and age on bone biomarkers. RESULTS Five women were young (22 ± 2.8 years) and four were older (58 ± 1.8 years). Baseline bone biomarker levels did not differ by age (all P ≥ .07). Bone formation markers were lower after SRCD (estimate ± SEE, ΔP1NP = -9.5 ± 2.8 μg/L, P = .01; Δosteocalcin = -2.3 ± 0.9 ng/mL, P = .04). The P1NP decline was greater in young women (ΔP1NP = -12.9 ± 3.7 μg/L, P = .01). After SRCD, CTX was significantly higher in young women (0.182 ± 0.069 ng/mL, P = .04) but did not change in older women. CONCLUSIONS These pilot data are similar to previous findings in men and suggest that SRCD negatively altered bone metabolism in women by decreasing markers of bone formation and, in young women, increasing a marker of bone resorption. If sustained, this pattern of BTM uncoupling may lead to bone loss and lower bone mineral density.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, US
- Correspondence and Reprint Requests: Christine M. Swanson, MD, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave., Mail Stop 8106, Aurora, CO 80045. E-mail:
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, US
- OHSU-PSU School of Public Health, Portland, Oregon, US
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric Research, Education, and Clinical Center; Aurora, Colorado, US
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, US
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sean W Cain
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, US
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Mirjam Munch
- Sleep/Wake Research Centre, Massey University Wellington, Wellington, New Zealand
| | - Nina Vujović
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, US
| | - Charles A Czeisler
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, US
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, US
| | - Eric S Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon, US
| | - Orfeu M Buxton
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, US
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, US
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Swanson CM, Kohrt WM, Wolfe P, Wright KP, Shea SA, Cain SW, Munch M, Vujović N, Czeisler CA, Orwoll ES, Buxton OM. Rapid suppression of bone formation marker in response to sleep restriction and circadian disruption in men. Osteoporos Int 2019; 30:2485-2493. [PMID: 31446439 PMCID: PMC6879850 DOI: 10.1007/s00198-019-05135-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/16/2019] [Indexed: 01/25/2023]
Abstract
UNLABELLED We describe the time course of bone formation marker (P1NP) decline in men exposed to ~ 3 weeks of sleep restriction with concurrent circadian disruption. P1NP declined within 10 days and remained lower with ongoing exposure. These data suggest even brief exposure to sleep and circadian disruptions may disrupt bone metabolism. INTRODUCTION A serum bone formation marker (procollagen type 1 N-terminal, P1NP) was lower after ~ 3 weeks of sleep restriction combined with circadian disruption. We now describe the time course of decline. METHODS The ~ 3-week protocol included two segments: "baseline," ≥ 10-h sleep opportunity/day × 5 days; "forced desynchrony" (FD), recurring 28 h day (circadian disruption) with sleep restriction (~ 5.6-h sleep per 24 h). Fasted plasma P1NP was measured throughout the protocol in nine men (20-59 years old). We tested the hypothesis that PINP would steadily decline across the FD intervention because the magnitude of sleep loss and circadian misalignment accrued as the protocol progressed. A piecewise linear regression model was used to estimate the slope (β) as ΔP1NP per 24 h with a change point mid-protocol to estimate the initial vs. prolonged effects of FD exposure. RESULTS Plasma P1NP levels declined significantly within the first 10 days of FD ([Formula: see text] = - 1.33 μg/L per 24 h, p < 0.0001) and remained lower than baseline with prolonged exposure out to 3 weeks ([Formula: see text] = - 0.18 μg/L per 24 h, p = 0.67). As previously reported, levels of a bone resorption marker (C-telopeptide (CTX)) were unchanged. CONCLUSION Sleep restriction with concurrent circadian disruption induced a relatively rapid decline in P1NP (despite no change in CTX) and levels remained lower with ongoing exposure. These data suggest (1) even brief sleep restriction and circadian disruption can adversely affect bone metabolism, and (2) there is no P1NP recovery with ongoing exposure that, taken together, could lead to lower bone density over time.
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Affiliation(s)
- C M Swanson
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA.
| | - W M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center, Aurora, CO, USA
| | - P Wolfe
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K P Wright
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - S A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
- OHSU-PSU School of Public Health, Portland, OR, USA
| | - S W Cain
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, 3800, Australia
| | - M Munch
- Institute of Physiology, Charité University Medicine Berlin, Berlin, Germany
- Sleep/Wake Research Centre, Massey University Wellington Campus, Wellington, New Zealand
| | - N Vujović
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - C A Czeisler
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - E S Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - O M Buxton
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Biobehavioral Health, Pennsylvania State University, University Park, State College, PA, USA
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Bone Health and BMD Research in Pediatric and Adolescent Individuals with ASD: Current Data, Evaluation, and Next Steps. Clin Rev Bone Miner Metab 2019. [DOI: 10.1007/s12018-019-09268-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Micronutrient Inadequacy in Short Sleep: Analysis of the NHANES 2005-2016. Nutrients 2019; 11:nu11102335. [PMID: 31581561 PMCID: PMC6835726 DOI: 10.3390/nu11102335] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 01/21/2023] Open
Abstract
One third of U.S. adults report short sleep (<7 h), which has been linked to negative health outcomes. Inadequate intake of micronutrients across the U.S. adult population has been reported, and a relationship between sleep conditions and micronutrient intake is emerging. This cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES 2005–2016) (n = 26,211) showed that participants with short sleep duration had a lower usual intake (Food + Supplements) of calcium, magnesium, and vitamin D in all adults aged 19+ years, and vitamin K in adults aged 19–50 years, even after adjusting for covariates. In addition, participants reporting short sleep had a higher percentage of individuals with intake lower than the estimated average requirement (EAR) across multiple nutrients. Age and gender differences were observed in the prevalence of inadequate intake across multiple nutrients. Adults aged 51–99 years with short sleep duration had inadequate intake with respect to more nutrients. In females there was an association between short sleep and a higher prevalence of inadequate intake (Food + Spp) for calcium, magnesium, and vitamins A, C, D, E, and K (above adequate intake). Conversely, males reporting short sleep only had an inadequate intake of vitamin D. Overall, we demonstrate that short sleep is associated with increased nutrient inadequacy, emphasizing the possible need for dietary supplementation.
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Swanson CM, Blatchford PJ, Orwoll ES, Cauley JA, LeBlanc ES, Fink HA, Wright KP, Wierman ME, Kohrt WM, Stone KL. Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF). Osteoporos Int 2019; 30:2087-2098. [PMID: 31139855 PMCID: PMC6800619 DOI: 10.1007/s00198-019-05007-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
Methodological limitations preclude determination of the association between sleep duration and bone mineral density (BMD) from existing literature. This was the first study to use objective sleep duration to determine its association with BMD. Nocturnal sleep duration, assessed objectively (actigraphy) or subjectively (questionnaire), was not independently associated with BMD in postmenopausal women. INTRODUCTION Both long and short self-reported sleep durations are associated with low bone mineral density (BMD) in men and women. The association between sleep duration measured by actigraphy and BMD in postmenopausal women is unknown. METHODS The Study of Osteoporotic Fractures (SOF) ancillary sleep study was used to determine the association between sleep duration and BMD at the total hip and femoral neck in postmenopausal women ≥ 75 years old. Sleep duration was assessed by wrist actigraphy (average 4 nights) and questionnaire. BMD was compared between postmenopausal women with short (< 6 h/night) vs. NIH-recommended (7-8 h/night) sleep durations. Data were analyzed using a 2-sample t test (unadjusted) and multivariate regression model (adjusted). Simple linear regression was used to estimate the difference in BMD per additional hour of sleep when sleep duration was considered as a continuous, rather than dichotomized, variable. RESULTS Total hip BMD was higher in women with actigraphically assessed shorter sleep duration in unadjusted models only. No clinically or statistically significant differences in total hip or femoral neck BMD were observed according to nocturnal sleep duration after adjusting for body mass index (BMI) in dichotomized (N = 874) or continuous (N = 1624) sleep duration models or when subjective sleep duration was used. When sleep duration included daytime naps, longer sleep duration was associated with lower total hip BMD (β = - 0.005, p = 0.04). CONCLUSIONS Nocturnal sleep duration, whether assessed objectively (actigraphy) or subjectively (questionnaire), was not independently associated with BMD in older postmenopausal women.
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Affiliation(s)
- C M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - P J Blatchford
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - E S Orwoll
- Division of Endocrinology and Bone & Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - E S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR, USA
| | - H A Fink
- Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - K P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - M E Wierman
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Research Service, Rocky Mountain Regional Veterans Affairs Medical Center Aurora, Aurora, CO, USA
| | - W M Kohrt
- Division of Geriatric Medicine, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
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Xu X, Wang R, Sun Z, Wu R, Yan W, Jiang Q, Shi D. Trehalose enhances bone fracture healing in a rat sleep deprivation model. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:297. [PMID: 31475167 DOI: 10.21037/atm.2019.05.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background The purpose of this study was to investigate whether sleep deprivation (SD) could delay bone fracture healing and evaluate the therapeutic effect of trehalose. Methods Eighteen 300-350 g female Sprague-Dawley rats were created a mid-femoral transverse osteotomy in the right thigh and divided into three groups (i.e., group 1: fracture; group 2: fracture + SD; and group 3: fracture + SD + trehalose). Seven days after surgery, the rats in group 2 and group 3 were started to get sleep-deprived for 18 h per day for 3 weeks. The rats in group 3 were injected with trehalose intraperitoneally at 1 g/kg/d for 3 weeks. Radiological and histological analyses were used to assess fracture healing quality. Circulating cytokines were detected by the end of the study. The expression of M1 and M2 macrophage markers were measured by quantitative real-time polymerase chain reaction (qPCR). Results X-rays showed group 2 experienced much poorer fracture healing. Micro CT demonstrated that the bone quality of the fracture callus site in group 2 was much worse than that in groups 1 and 3. Both haematoxylin eosin (H&E) and Masson staining revealed that the bone fracture of the group 2 healed worse. Elisa results demonstrated that the interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) of the rats in group 2 were significantly higher. In vitro study showed that 100 mM trehalose enhanced the expression of M2 macrophage markers (Arg-1 and IL-10), and decreased M1 macrophage polarization through the decreasing expression of IL-6. Conclusions The present study showed (SD) could delay bone fracture healing in a rat model. And, trehalose could promote the healing of delayed bone fracture union by down-regulating pro-inflammatory mediators and enhancing M2 polarization.
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Affiliation(s)
- Xingquan Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Rongliang Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Ziying Sun
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Rui Wu
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Wenjin Yan
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
| | - Dongquan Shi
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.,Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing 210093, China
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Staab JS, Smith TJ, Wilson M, Montain SJ, Gaffney-Stomberg E. Bone turnover is altered during 72 h of sleep restriction: a controlled laboratory study. Endocrine 2019; 65:192-199. [PMID: 31028666 DOI: 10.1007/s12020-019-01937-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/11/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE The objective of the study was to evaluate how controlled, short-term sleep restriction (SR; 72 h) alters markers of bone formation and resorption and urinary calcium (Ca) output. METHODS Ten healthy, sleep-adequate, male soldiers were housed in the research facility one day prior to and for the duration of SR. Diet was controlled to provide adequate energy balance and macronutrient distribution, meeting the recommended dietary allowance (RDA) for Ca. Subjects engaged in light activities to maintain wakefulness and were allowed 2 h of sleep per night (0430-0630 hours). Blood samples were collected each morning at 0 h (baseline) and 24, 48, and 72 h of SR. Serum was assayed for parathyroid hormone (PTH), bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRAP), and C-terminal telopeptide of type I collagen (CTX). Urine was collected in 24 h increments during SR for measurement of Ca and creatinine (Cr). RESULTS BAP was reduced at 24 h (P= 0.015) and resorption markers TRAP and CTX were increased after 48 and 72 h of SR compared to baseline (P < 0.05). The ratio of BAP:TRAP was significantly lower (P= 0.017) at 48 and 72 h of SR. In contrast, total 24 h urinary Ca and Ca/Cr excretion were unchanged. CONCLUSIONS Markers of bone formation and resorption are uncoupled in response to as little as 48 h of SR even when Ca intake is at the RDA. Sleep deprivation may be a risk factor for reduced bone health due to perturbations in bone turnover.
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Affiliation(s)
- Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA.
| | - Tracey J Smith
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Marques Wilson
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Scott J Montain
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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Swanson CM, Kohrt WM, Buxton OM, Everson CA, Wright KP, Orwoll ES, Shea SA. The importance of the circadian system & sleep for bone health. Metabolism 2018; 84:28-43. [PMID: 29229227 PMCID: PMC5994176 DOI: 10.1016/j.metabol.2017.12.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/28/2017] [Accepted: 12/01/2017] [Indexed: 01/01/2023]
Abstract
Adequate sleep timed appropriately during the circadian night is important for numerous biological processes and systems. New evidence suggests that both sleep timing and duration may be important for optimal bone health as well. This review examines the diurnal variation of bone turnover markers (BTMs) and the importance of circadian clock genes in regulating bone mass. In addition, this review explores the evidence for a link between shift work (and its associated disturbances in sleep duration/quality and circadian alignment) and alterations in bone metabolism and bone health. Finally, we review how commonly used medications and over-the-counter substances (e.g. caffeine, melatonin) complicate the relationship between sleep and circadian disorders and bone health.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Eastern Colorado VA Geriatric, Research, Education, and Clinical Center, Aurora, CO, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, MA, USA
| | - Carol A Everson
- Department of Medicine, Division of Endocrinology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Eric S Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA; OHSU-PSU School of Public Health, Portland, OR, USA
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Maria S, Samsonraj RM, Munmun F, Glas J, Silvestros M, Kotlarczyk MP, Rylands R, Dudakovic A, van Wijnen AJ, Enderby LT, Lassila H, Dodda B, Davis VL, Balk J, Burow M, Bunnell BA, Witt-Enderby PA. Biological effects of melatonin on osteoblast/osteoclast cocultures, bone, and quality of life: Implications of a role for MT2 melatonin receptors, MEK1/2, and MEK5 in melatonin-mediated osteoblastogenesis. J Pineal Res 2018; 64:10.1111/jpi.12465. [PMID: 29285799 PMCID: PMC6711668 DOI: 10.1111/jpi.12465] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/13/2017] [Indexed: 01/05/2023]
Abstract
The Melatonin Osteoporosis Prevention Study (MOPS) demonstrated that nightly melatonin resulted in a time-dependent decrease in equilibrium ratios of serum osteoclasts and osteoblasts in perimenopausal women. This study examines mechanisms related to the ratios of osteoblasts and osteoclasts using coculture models (transwell or layered) of human mesenchymal stem cell (MSC) and human peripheral blood monocytes (PBMCs). Human MSC/PBMC cocultures exposed to melatonin in osteogenic (OS+) medium for 21 days induced osteoblast differentiation and mineralization; however, only in layered cocultures did melatonin inhibit osteoclastogenesis. Melatonin effects were mediated through MT2 melatonin receptors, MEK1/2, and MEK5. In layered but not transwell cocultures, melatonin increased OPG:RANKL ratios by inhibiting RANKL, suggesting that contact with osteoclasts during osteoblastogenesis inhibits RANKL secretion. Melatonin modulated expression of ERK1/2, ERK5, β1 integrin, GLUT4, and IRβ that was dependent upon the type of coculture; however, in both cultures, melatonin increased RUNX2 and decreased PPARγ expression, indicating a role for metabolic processes that control osteogenic vs adipogenic cell fates of MSCs. Furthermore, melatonin also has osteoblast-inducing effects on human adipose-derived MSCs. In vivo, one-year nightly melatonin (15 mg/L) given to neu female mice in their drinking water increased pErk1/2, pErk5, Runx2, and Opg and Rankl levels in bone consistent with melatonin's already reported bone-enhancing effects. Finally, analysis of daily logs from the MOPS demonstrated a significant improvement in mood and perhaps sleep quality in women receiving melatonin vs placebo. The osteoblast-inducing, bone-enhancing effects of melatonin and improvement in quality of life suggest that melatonin is a safe and effective bone loss therapy.
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Affiliation(s)
- Sifat Maria
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | | | - Fahima Munmun
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Jessica Glas
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Maria Silvestros
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Mary P. Kotlarczyk
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Ryan Rylands
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Amel Dudakovic
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Holly Lassila
- Division of Clinical Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Bala Dodda
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Vicki L. Davis
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Judy Balk
- West Penn/Allegheny Health System, Drexel University and Temple University, Pittsburgh, PA, USA
| | - Matt Burow
- Center for Stem Cell Research and Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Bruce A. Bunnell
- Center for Stem Cell Research and Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Paula A. Witt-Enderby
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
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Han K, Park YM, Park JB. Evaluation of an association between long sleep duration and periodontal disease among men and women using nationally representative data. GACETA SANITARIA 2018; 32:143-150. [DOI: 10.1016/j.gaceta.2017.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/10/2017] [Accepted: 01/23/2017] [Indexed: 02/08/2023]
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Swanson CM, Shea SA, Wolfe P, Cain SW, Munch M, Vujović N, Czeisler CA, Buxton OM, Orwoll ES. Bone Turnover Markers After Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans. J Clin Endocrinol Metab 2017; 102:3722-3730. [PMID: 28973223 PMCID: PMC5630251 DOI: 10.1210/jc.2017-01147] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/21/2017] [Indexed: 12/26/2022]
Abstract
CONTEXT Sleep abnormalities are associated with low bone mineral density. Underlying mechanisms are unknown. OBJECTIVE Investigate the impact of sleep restriction with circadian disruption on bone biomarkers. DESIGN Intervention study. PARTICIPANTS AND METHODS Four bone biomarkers [C-terminal cross-linked telopeptide of type I collagen (CTX) = bone resorption, N-terminal propeptide of type I procollagen (P1NP) = bone formation, sclerostin and fibroblast growth factor 23 = osteocyte function] were measured in bihourly serum samples over 24 hours at baseline and after ∼3 weeks of sleep restriction (5.6 hours sleep/24 hours) with concurrent circadian disruption (recurring 28-hour "day" in dim light) in 10 men (age groups: 20 to 27 years, n = 6; 55 to 65 years, n = 4). The effects of sleep/circadian disruption and age on bone biomarker levels were evaluated using maximum likelihood estimation in a mixed model for repeated measures. RESULTS P1NP levels were lower after intervention compared with baseline (P < 0.001); the decrease in P1NP was greater for younger compared with older men (28.0% vs 18.2%, P < 0.001). There was no change in CTX (Δ = 0.03 ± 0.02 ng/mL, P = 0.10). Sclerostin levels were higher postintervention in the younger men only (Δ = 22.9% or 5.64 ± 1.10 pmol/L, P < 0.001). CONCLUSIONS These data suggest that 3 weeks of circadian disruption with concurrent sleep restriction can lead to an uncoupling of bone turnover wherein bone formation is decreased but bone resorption is unchanged. Circadian disruption and sleep restriction may be most detrimental to bone in early adulthood.
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Affiliation(s)
- Christine M. Swanson
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239
- Division of Endocrinology, University of Colorado, Aurora, Colorado 80045
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon 97239
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Oregon Health & Science University and Portland State University School of Public Health, Portland, Oregon 97239
| | - Pamela Wolfe
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - Sean W. Cain
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria 3800, Australia
| | - Mirjam Munch
- Charité University Medicine Berlin, Institute of Physiology, 10117 Berlin, Germany
| | - Nina Vujović
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Charles A. Czeisler
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Orfeu M. Buxton
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania 16802
- Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, Massachusetts 02115
| | - Eric S. Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239
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Liguori C, Izzi F, Mercuri NB, Tarantino U, Placidi F. Physical activity contradictorily affects bone mineral density in obstructive sleep apnea patients at different ages. Sleep Med 2017; 32:273. [PMID: 28065400 DOI: 10.1016/j.sleep.2016.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 09/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Claudio Liguori
- Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Francesca Izzi
- Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Umberto Tarantino
- Department of Orthopedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy
| | - Fabio Placidi
- Sleep Medicine Centre, Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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