Dataset Information

Self-reported sleep characteristics and risk for incident vertebral and hip fracture in women.

ABSTRACT:

Objective

To examine the relationships between self-reported sleep characteristics and risk of incident vertebral fracture and hip fracture in women.

Design

Longitudinal cohort study.

Setting

Nurses' Health Studies (NHS: 2002-2014, NHSII: 2001-2015).

Participants

Total 122,254 female registered nurses (46,129 NHS, 76,125 NHSII) without prior history of fracture.

Exposure

Sleep was characterized by 4 sleep-related domains-sleep duration, sleep difficulty, snoring, and excessive daytime sleepiness-assessed by self-reported questionnaires.

Outcomes

Self-reports of vertebral fracture were confirmed by medical record review and hip fracture was assessed by biennial questionnaires.

Results

Over 12-14 years of follow-up, 569 incident vertebral fracture cases (408 in NHS, 161 in NHSII) and 1,881 hip fracture cases (1,490 in NHS, 391 in NHSII) were documented. In the pooled analysis, the multivariable-adjusted HR (95% CI) for vertebral fracture was 1.20 (0.86, 1.66) for sleep duration ≤5 hours vs. 7 hours and 0.82 (0.60, 1.12) for ≥9 vs. 7 hours; 1.63 (0.93, 2.87) for sleep difficulties all-the-time vs. none/little-of-the-time (p-trend = 0.005); 1.47 (1.05, 2.05) for snoring every night/week vs. never/occasionally (p-trend = 0.03), and 2.20 (1.49, 3.25) for excessive daytime sleepiness daily vs. never (p-trend < 0.001). In contrast, associations were not observed with hip fracture risk.

Conclusion

Poorer sleep characteristics were associated with risk of vertebral fracture. Our study highlights the importance of multiple dimensions of sleep in the development of vertebral fractures. Further research is warranted to understand the role of sleep in bone health that may differ by fracture site, as well as sleep interventions that may reduce the risk of fracture.

SUBMITTER: Huang T

PROVIDER: S-EPMC8995338 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self-reported sleep characteristics and risk for incident vertebral and hip fracture in women.

Huang Tianyi T Redline Susan S Gordon Catherine M CM Schernhammer Eva E Curhan Gary C GC Paik Julie M JM

Sleep health 20220228 2

<h4>Objective</h4>To examine the relationships between self-reported sleep characteristics and risk of incident vertebral fracture and hip fracture in women.<h4>Design</h4>Longitudinal cohort study.<h4>Setting</h4>Nurses' Health Studies (NHS: 2002-2014, NHSII: 2001-2015).<h4>Participants</h4>Total 122,254 female registered nurses (46,129 NHS, 76,125 NHSII) without prior history of fracture.<h4>Exposure</h4>Sleep was characterized by 4 sleep-related domains-sleep duration, sleep difficulty, snori ...[more]

PMID: 35241403

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Project description:Recent studies suggest a positive association between obstructive sleep apnea (OSA), a disorder associated with intermittent hypoxia and sleep fragmentation, and derangements in bone metabolism. However, no prospective study to date has investigated the association between OSA and fracture risk in women. We conducted a prospective study examining the relation between OSA and risk of incident vertebral fracture (VF) and hip fracture (HF) in the Nurses' Health Study. History of physician-diagnosed OSA was assessed by self-reported questionnaires. A previous validation study demonstrated high concordance between self-reports and medical record identification of OSA. OSA severity was further categorized according to the presence or absence of self-reported sleepiness. Self-reports of VF were confirmed by medical record review. Self-reported HF was assessed by biennial questionnaires. Cox proportional-hazards models estimated the hazard ratio for fracture according to OSA status, adjusted for potential confounders, including BMI, physical activity, calcium intake, history of osteoporosis, and falls, and use of sleep medications. Among 55,264 women without prior history of fracture, physician-diagnosed OSA was self-reported in 1.3% in 2002 and increased to 3.3% by 2012. Between 2002 and 2014, 461 incident VF cases and 921 incident HF cases were documented. The multivariable-adjusted hazard ratio (HR) for confirmed VF for women with history of OSA was 2.00 (95% CI, 1.29-3.12) compared with no OSA history, with the strongest association observed for OSA with daytime sleepiness (HR 2.86; 95% CI, 1.31-6.21). No association was observed between OSA history and self-reported HF risk (HR 0.83; 95% CI, 0.49-1.43). History of OSA is independently associated with higher risk of confirmed VF but did not have a statistically significant association with self-reported HF in women. Further research is warranted in understanding the role of OSA and intermittent hypoxia in bone metabolism and health that may differ by fracture site. © 2020 American Society for Bone and Mineral Research (ASBMR).

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Dataset Information

Self-reported sleep characteristics and risk for incident vertebral and hip fracture in women.

Objective

Design

Setting

Participants

Exposure

Outcomes

Results

Conclusion

Publications

Self-reported sleep characteristics and risk for incident vertebral and hip fracture in women.

Similar Datasets

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