Impact of sleep on osteoporosis: sleep quality is associated with bone stiffness index

•The impact of sleep quality on osteoporosis was examined.•A total of 1032 participants were included in this cross-sectional analysis.•Poor sleep quality correlated with osteoporosis, whereas sleep quantity did not.•Consequently, sleep may be another lifestyle factor contributing to osteoporosis.

ObjectiveThe aim of the present study was to investigate the impact of sleep on osteoporosis.MethodsThe study used a baseline examination of the Hiroshima Sleep and Healthcare study, which was a cross-sectional and cohort study that addressed the association of sleep habits with lifestyle-related diseases. A total of 1032 participants (25-85 years of age) who underwent health examinations were included. Sleep habits, including its timing (bed time), quantity (time in bed [TIB]), and quality, were assessed using the Pittsburgh Sleep Quality Index (PSQI). The bone stiffness index (SI), a marker of osteoporosis, was measured using quantitative ultrasound systems.ResultsBed time (r = 0.065, p <0.05), TIB (r = −0.064, p <0.05), and global PSQI score (r = −0.126, p <0.0001) significantly correlated with SI. Multiple regression analyses revealed that after adjusting for age, sex, body mass index, smoking, and alcohol intake, the global PSQI score (β = −0.053, p <0.05) was significantly associated with SI, whereas bed time or TIB was not. Among each component of PSQI, sleep disturbances (β = −0.084, p <0.005) were significantly associated with SI.ConclusionPoor sleep quality may be associated with osteoporosis. In particular, increased sleep disturbances may be a key factor in the association between poor sleep quality and osteoporosis.