Lack of Sleep May Pose Osteoporosis Risk

by Martin Reed Patient Advocate

Insomnia can increase the risk of developing a number of health complications such as memory loss, depression, obesity, and even heart failure. New research also suggests that sleep disorders such as sleep apnea and insomnia may increase the risk of osteoporosis.

A study published in _Sleep Medicine _identified more than 44,000 individuals who were newly diagnosed with a sleep disorder. The study found that:*Those with a non-apnea sleep disorder (such as insomnia) were 2.76 times more likely to develop osteoporosis than those without a sleep disorder.

  • Those with an apnea sleep disorder were 2.98 times more likely to develop osteoporosis than those without a sleep disorder.

A separate, four-year study published in the Journal of American Geriatrics Society found that people who slept for less than six hours per night were at a higher risk for osteoporosis.

Even after accounting for age, there was still a significant increase in risk for those with the shortest sleep durations.

Why is there a link between osteoporosis and sleep?

Unfortunately, we still don't know for sure. There are plenty of theories, though.

Sleep deprivation leads to an inflammatory response inside the body. Cytokines (the inflammatory messengers) are thought to affect bone cell function, which may explain the increased osteoporosis risk in those who don't get enough sleep.

The inflammatory response is an important regulator of bone renewal. Higher cortisol levels lead to higher levels of glucocorticoids (a steroid hormone that can suppress bone formation and reduce bone strength and quality).

Sleep apnea can also lead to hypoxia, or oxygen deficiency, which has a negative impact on bone cell function.

Since osteoporosis is more common in older individuals who usually have other health conditions, it's thought that these other conditions (and the medications associated with them) may play a role. For example, studies have found that those with type 2 diabetes and cancer are at a higher risk for osteoporosis, while certain antipsychotic medications for schizophrenia can increase prolactin levels, which may be associated with bone density.

How to reduce osteoporosis riskThe best thing you can do is take steps to improve your sleep.

Those taking some anti-anxiety and anti-insomnia drugs like benzodiazepines and zolpidem have been found to have higher rates of osteoporosis. If you're taking these medications, you may want to speak with your doctor to see if there are any alternatives.

Remember that sleeping pills such as zolpidem (Ambien) are not recommended for long term use. Alternative interventions for insomnia include cognitive behavioral therapy and sleep hygiene improvements.

Obstructive sleep apnea (OSA) has been linked to abnormal bone metabolism and research from a 2016 study published in Sleep Medicine, suggests that not getting enough sleep can lead to lower bone marrow density. If you suspect you are suffering from OSA, speak with your doctor, who may prescribe CPAP (continuous positive airway pressure) to help keep your airway open.

Finally, consider speaking with your doctor to see if a change in medications could reduce your osteoporosis risk. For example, if you're being treated for hypertension with calcium channel blockers you may want to explore the option of switching to beta blockers.


Cunningham, Tina D., and Brian S. Di Pace. "Is Self"Reported Sleep Duration Associated with Osteoporosis? Data from a 4"Year Aggregated Analysis from the National Health and Nutrition Examination Survey." Journal of American Geriatrics Society 63.7 (2015): 1401-1406. Accessed May 25, 2016.

Yen, Chia-Ming, Chi-Ling Kuo, Ming-Chia Lin, Chun-Feng Lee, Kuan-Yu Lin, Cheng-Li Lin, Shih-Ni Chang, Fung-Chang Sung, and Chia-Hung Kao. "Sleep disorders increase the risk of osteoporosis: a nationwide population-based cohort study." Sleep Medicine 15.11 (2014): 1339-1344. Accessed May 25, 2016.

Martin is the creator of Insomnia Land’s free insomnia sleep training course. His online course teaches participantshow to fall asleep and stay asleep. Over 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.