Sleep duration and the risk of osteoporosis among middle-aged and elderly adults: a dose-response meta-analysis

It remains unclear how many hours of sleep are associated with the lowest risk of osteoporosis. This meta-analysis was performed to assess the dose-response relationship between sleep duration and risk of osteoporosis. PubMed and Web of Science were searched from inception to December 3, 2017, supplemented by manual searches of the bibliographies of retrieved articles. Data were pooled using fixed- and random-effects models. Restricted cubic spline analysis with four knots was used to model the sleep duration and osteoporosis association. Four cross-sectional studies with eight records were eligible for inclusion in the meta-analysis. A U-shaped dose-response relationship was observed between sleep duration and risk of osteoporosis, with the lowest risk observed at a sleep duration category of 8-9 h per day. Compared with 8-h sleep duration per day, the pooled odds ratio for osteoporosis were 1.03 (95% CI 1.01-1.06) for each 1-h reduction among individuals with shorter sleep duration and 1.01 (95% CI 1.00-1.02) for each 1-h increment among individuals with longer sleep duration. Our dose-response meta-analysis shows a U-shaped relationship between sleep duration and risk of osteoporosis, with the lowest osteoporosis risk at about 8 h per day of sleep duration. Both short and long sleep duration is associated with a significantly increased risk of osteoporosis in the middle-aged and elderly adults, appropriate sleep duration could help for delay or prevention of osteoporosis.