How Sleep Affects Osteoporosis Risk and Bone Health

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Sleep disturbances are linked with health risks such as heart disease and diabetes, and living with a chronic condition can certainly make sleep even more difficult. If you are living with osteoporosis, here’s everything you need to know about how sleep (particularly a lack of it) can affect bone health.


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Sleep influences osteoporosis risk

Carolyn Dean, M.D., a doctor and nutrition expert on the Medical Advisory Board for the Nutritional Magnesium Association, spoke with HealthCentral by email about osteoporosis and sleep. She reported that poor sleep can increase the risk of osteoporosis and lower bone density. Here are some of the reasons why.


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Poor sleep hinders bone regeneration

“The purpose of quality sleep is to repair the body and recover from the daily exertions of life,” Dr. Dean says. Therefore, a lack of sleep can inhibit new bone formation and bone regeneration. According to Dr. Dean, this can cause cell damage and result in abnormal bone marrow — an indicator that normal bone repair is being negatively affected.


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The problems of sleep apnea and insomnia

To support these claims, Dr. Dean pointed to a study that found osteoporosis was nearly three times more common among those with sleep apnea compared with those without the sleep disorder, and another that found insomnia was associated with a 52 percent increased risk of osteoporosis.


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Why does poor sleep harm bone health?

“Bad sleep stresses the body and forces bone building minerals such as magnesium away from their normal function of strengthening bone into stress related functions,” says Dr. Dean. Magnesium is particularly important since it stimulates calcitonin, a hormone that helps to preserve bone structure and lower the likelihood of osteoporosis.


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Sleep deprivation and inflammation

If we don’t get enough sleep, an inflammatory response occurs in the body. Cytokines (inflammatory messengers) can affect bone cell function and the high cortisol levels association with inflammation can suppress bone formation and reduce bone strength, making fractures more likely.


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Poor sleep reduces bone flexibility

“Our bones are in a constant cycle of repair in which mature bone tissue is removed and replaced with new bone tissue,” said holistic nutritionist Miriam Amselem in an email to HealthCentral. “A lack of sleep can hinder this repair process and reduce the strength, flexibility and density of our bones — all of which can increase fracture risk.”


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The role of sleeping pills

If you rely on sleeping pills to get through the night, your bone health may suffer. A 2016 article published in Mayo Clinic Proceedings stated that sleep aids such as benzodiazepines can increase fracture risk while antidepressants such as selective serotonin reuptake inhibitors (SSRIs) can decrease bone mineral density. These findings led the authors to suggest alternatives to medication such as cognitive behavioral therapy for older adults with insomnia and anxiety.


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Hormone and vitamin activity

In an email to HealthCentral, Adam Rivadeneyra, M.D., a board-certified primary care and sports medicine physician at Hoag Orthopedic Institute, said that as little as three weeks of reduced sleep quality and quantity increases bone breakdown. This could be because of the way sleep affects hormone production and vitamin conversion. “Growth hormone, calcium regulating hormones and vitamin D conversion all benefit from improved sleep,” Dr. Rivadeneyra says.


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The role of vitamin D

It’s important to make sure you get enough vitamin D because it helps to keep bones strong and healthy. This vitamin plays an important role when it comes to sleep health, too — research has found that poor sleep quality is linked to low levels of vitamin D. If you don’t get enough vitamin D from sun exposure or your diet (the recommended dietary allowance for adults over 51 years old is 600-800 IU daily), you may want to consider supplements. A light therapy lamp may also help.


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The role of calcium

Calcium also plays an important role when it comes to bone health; if we don’t consume enough of this mineral, our body will take what it needs from our bones. Making sure you eat plenty of calcium-rich foods will not only be good for your bones, but it may improve sleep as well because it helps the brain produce melatonin, an important sleep hormone.


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Stay fit to improve sleep and bone health

Last, but not least, don't forget to exercise. Although sleep changes as we get older, it never becomes less important. And not only can exercise improve sleep, but there are also a number of specific exercises that can strengthen your bones. This takes on added importance since, as we age, we also become more prone to falls — particularly when sleep deprived.