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Self-reported sleep quality and bone outcomes in older adults: findings from the Hertfordshire Cohort Study

Self-reported sleep quality and bone outcomes in older adults: findings from the Hertfordshire Cohort Study
Self-reported sleep quality and bone outcomes in older adults: findings from the Hertfordshire Cohort Study

Sleep duration may be associated with risk of osteoporosis, with suggestions that too little or indeed too much sleep may be detrimental to bone health. In this study, we considered whether perceived sleep quality is also associated with bone health in older adults. We explored this association in a cohort of 443 older community-dwelling UK adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as > 5 on this score system. Bone density, shape and microarchitecture were assessed using dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HRpQCT). Thirty-seven percent of men and 43% of women had a PSQI score greater than 5, indicative of poor perceived sleep. We found that quality of sleep was associated with altered bone microarchitecture. In men, poor sleep quality was associated with lower radial trabecular (4% slice, p < 0.04) and cortical (66% slice, p = 0.02) bone mineral density, as well as decreased tibial cortical density (p < 0.02) and increased porosity (p < 0.04), but increased size of the tibia (p < 0.04). In women, poor perceived sleep quality was associated with thinner (p < 0.03) and less dense (p < 0.04) cortices of the radius, but greater tibial trabecular number (p < 0.02) and lower separation (p < 0.04). Relationships with DXA parameters were non-significant after adjustment for confounders. Taking sleep medications was associated with decreased tibial size (38% and 66% slices) and strength in women (all p < 0.05), but not in men. Perceived sleep quality was associated with altered bone density and microarchitecture in older adults, and these differences varied according to biological sex and site. Further work is indicated to investigate possible mechanisms underlying these observations.

Ageing, Bone density, Bone microarchitecture, Computed tomography, Older adults, Sleep quality
0171-967X
455-464
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Denison, Hayley J.
65475cfd-bdb1-4b02-844e-b2e8f0b1ac46
Laskou, Faidra
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Jameson, Karen
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Ward, Kathryn
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Cooper, Cyrus
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Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Denison, Hayley J.
65475cfd-bdb1-4b02-844e-b2e8f0b1ac46
Laskou, Faidra
8484c4de-76e9-414e-9614-e035f25cae7e
Jameson, Karen
d5fb142d-06af-456e-9016-17497f94e9f2
Ward, Kathryn
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Bevilacqua, Gregorio, Denison, Hayley J., Laskou, Faidra, Jameson, Karen, Ward, Kathryn, Cooper, Cyrus and Dennison, Elaine (2020) Self-reported sleep quality and bone outcomes in older adults: findings from the Hertfordshire Cohort Study. Calcified Tissue International, 106 (5), 455-464. (doi:10.1007/s00223-020-00657-8).

Record type: Article

Abstract

Sleep duration may be associated with risk of osteoporosis, with suggestions that too little or indeed too much sleep may be detrimental to bone health. In this study, we considered whether perceived sleep quality is also associated with bone health in older adults. We explored this association in a cohort of 443 older community-dwelling UK adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as > 5 on this score system. Bone density, shape and microarchitecture were assessed using dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high-resolution pQCT (HRpQCT). Thirty-seven percent of men and 43% of women had a PSQI score greater than 5, indicative of poor perceived sleep. We found that quality of sleep was associated with altered bone microarchitecture. In men, poor sleep quality was associated with lower radial trabecular (4% slice, p < 0.04) and cortical (66% slice, p = 0.02) bone mineral density, as well as decreased tibial cortical density (p < 0.02) and increased porosity (p < 0.04), but increased size of the tibia (p < 0.04). In women, poor perceived sleep quality was associated with thinner (p < 0.03) and less dense (p < 0.04) cortices of the radius, but greater tibial trabecular number (p < 0.02) and lower separation (p < 0.04). Relationships with DXA parameters were non-significant after adjustment for confounders. Taking sleep medications was associated with decreased tibial size (38% and 66% slices) and strength in women (all p < 0.05), but not in men. Perceived sleep quality was associated with altered bone density and microarchitecture in older adults, and these differences varied according to biological sex and site. Further work is indicated to investigate possible mechanisms underlying these observations.

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CTI - G Bevilacqua - Accepted Manuscript
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Accepted/In Press date: 7 January 2020
e-pub ahead of print date: 18 January 2020
Published date: 1 May 2020
Additional Information: Funding Information: We are extremely grateful to the Hertfordshire Study Cohort participants who took part in each stage of this research, Versus Arthritis, the Medical Research Council of Great Britain and the Porticus Foundation funded the study. Kate A. Ward’s research is part-supported by MRC Programme Number U105960371. Publisher Copyright: © 2020, The Author(s).
Keywords: Ageing, Bone density, Bone microarchitecture, Computed tomography, Older adults, Sleep quality

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Local EPrints ID: 437057
URI: http://eprints.soton.ac.uk/id/eprint/437057
ISSN: 0171-967X
PURE UUID: d8631e19-1437-4bb1-993d-d503c57eeabc
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Kathryn Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 16 Jan 2020 17:31
Last modified: 18 Mar 2024 05:08

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Contributors

Author: Gregorio Bevilacqua ORCID iD
Author: Hayley J. Denison
Author: Faidra Laskou
Author: Karen Jameson
Author: Kathryn Ward ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD

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