The associations of bedtime, nocturnal, and daytime sleep duration with bone mineral density in pre- and post-menopausal
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ORIGINAL ARTICLE
The associations of bedtime, nocturnal, and daytime sleep duration with bone mineral density in pre- and post-menopausal women Kun Wang • Yang Wu • Yu Yang • Jie Chen • Danyu Zhang Yongxin Hu • Zhoujun Liu • Juan Xu • Qiaoxuan Shen • Niya Zhang • Xiaodong Mao • Chao Liu
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Received: 18 October 2014 / Accepted: 24 November 2014 Ó Springer Science+Business Media New York 2014
Abstract To explore the association of sleep patterns with bone mineral density (BMD) in pre- and post-menopausal women, we used a questionnaire to evaluate the sleep patterns and performed calcaneal quantitative ultrasound to estimate BMD, in 6,510 women aged 40 years or older, from June to November 2011 in Nanjing City. We found a 1.7-fold risk of osteoporosis in post-menopausalwomen with bedtime of C0:00 am (OR = 1.69, 95 % CI 1.39–2.13), compared to those whose bedtime of\0:00 am. post-menopausalwomen with excessive total sleep ([10 h vs. 8–9 h, OR = 1.54, 95 % CI 1.05–2.02) were shown to have a higher risk of osteoporosis, however, this high risk was not detected in those with excessive nocturnal sleep ([10 h vs. 8–9 h, OR = 0.85, 95 % CI 0.62–1.30). By contrast, post-menopausalwomen with inadequate nocturnal sleep (B7 h vs. 8–9 h, OR = 1.68, 95 % CI 1.32–2.75), excessive daytime sleep (C180 min vs. 0 min, OR = 1.52, 95 % CI 1.08–2.13), and noontime nap ([60 min vs. 0 min: OR = 1.37, 95 % CI 1.06–1.76) were demonstrated to have higher risk of bone loss. Nevertheless, these associations were not found in premenopausal women. We conclude that delayed bedtime, nocturnal sleep deprivation, Kun Wang and Yang Wu have contributed equally to this study. K. Wang Y. Yang J. Chen D. Zhang Y. Hu Z. Liu J. Xu Q. Shen N. Zhang X. Mao C. Liu (&) Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100, Hongshan Road, Nanjing 210028, China e-mail: [email protected] Y. Wu Department of Endocrinology, The First People’s Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, 185, Juqian Road, Changzhou 213003, China
excessive daytime sleep, and noontime nap, but not reduced total sleep duration, could promote bone loss in post-menopausalwomen, which might be related to circadian rhythm disturbances. However, they have limited influences to BMD in women who were still in menstruating. Mechanism responsible for the phenomena warrants further investigation. Keywords Bedtime Nocturnal sleep duration Daytime sleep duration Bone mineral density (BMD) Osteoporosis
Introduction Delayed bedtime is an important characteristic of sleep disorder, which is considered associated with various diseases [1]. Several researches showed that sleep disorder might contribute to osteopenia and osteoporosis [2–4], the mechanism responsible remains unclear. Previous studies have focused on the influence of total sleep duration to the bone loss, because inadequate sleep might lead to the endocrine and metabolic dysfunction [5]. A
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