Association Between Sleep Duration and Low Bone Mineral Density and Osteoporosis: A Systematic Review and Meta-analysis.

Short and long sleep duration have been linked with adverse health outcomes. However, it is unclear if sleep duration affects the risk of low bone mineral density (BMD) or osteoporosis. We systematically reviewed evidence examining the association between short and long sleep with BMD/osteoporosis. PUBMED, Embase, CENTRAL, Web of Science, and Scopus were examined for studies up to July 15, 2024. We pooled adjusted odds ratio (OR) for the association between sleep and osteoporosis and adjusted linear regression coefficients (β) for BMD. A separate analysis was conducted for males, females, postmenopausal females, and the elderly. 14 studies were included. Three were cohort, while the rest were cross-sectional. The definition of short and long sleep varied among studies. Meta-analysis showed that long (OR 1.19 95% CI 1.05, 1.35 I² = 72%) but not short (OR 1.11 95% CI 0.95, 1.29 I² = 80%) sleep duration was associated with osteoporosis. Similar results were obtained for females and postmenopausal females. In males, both short and long sleep was associated osteoporosis while no such association was noted in the elderly. Meta-analysis showed that short sleep did not have any significant association with BMD (β - 0.002 95% CI - 0.007, 0.004 I² = 0), while long sleep duration was associated with a reduction in BMD (β - 0.017 95% CI - 0.031, - 0.004 I² = 0). Separate analyses for males and females revealed non-significant results. Evidence from mostly cross-sectional data suggests that long sleep duration may be a related to BMD and osteoporosis. Short sleep was not found to be related to BMD and osteoporosis, except for males where a significant effect was noted. Given the low-quality evidence, results must be interpreted with caution.