Sleep duration and bone health measures in older men

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ORIGINAL ARTICLE

Sleep duration and bone health measures in older men C. M. Swanson 1 & P. J. Blatchford 2 & K. L. Stone 3,4 & J. A. Cauley 5 & N. E. Lane 6 & T. S. Rogers-Soeder 7 & S. Redline 8,9 & D. C. Bauer 4,10 & K. P. Wright Jr 1,11 & M. E. Wierman 1,12 & W. M. Kohrt 13,14 & E. S. Orwoll 15 & for The Osteoporotic Fractures in Men (MrOS) Study Received: 12 May 2020 / Accepted: 1 September 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020

Abstract Summary 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.

Kohrt and Orwoll are co-senior authors * C. M. Swanson [email protected] 1

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Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA

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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

Division of Pulmonary Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

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University of California San Francisco Medical Center, San Francisco, CO, USA

Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA

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Departme