Annals of Medicine and Surgery · Sep 28, 2026
Association between bone mineral density, sleep disturbance, and sleep duration: Results from observational and mendelian randomization study
By Wang W, Huang F, You M et al.
Purpose: This study combines a nationally representative U.S. cohort with two-sample Mendelian randomization (MR) to examine associations of sleep disturbance and sleep duration with DXA-measured bone mineral density (BMD) at the femoral neck and lumbar spine. Methods: 6421 participants from NHANES 2007–2010 were included. Multivariable linear regression assessed associations between sleep disturbance, sleep duration, and BMD. Two-sample MR with five methods (primary: inverse variance-weighted) corroborated observational findings. Results: Sleep disturbance was negatively associated with BMD at the femoral neck [ β : −0.03; 95% confidence interval (CI): −0.04 to −0.02] and the lumbar spine ( β : −0.01; 95% CI: −0.02 to 0.00), and remained significant after adjustment (femoral neck: β : −0.01; 95% CI: −0.02 to −0.01; lumbar spine: β : −0.01; 95% CI: −0.02 to 0.00). No significant associations were found between sleep duration and BMD. MR showed consistent negative trends for the effect of sleep disorder on BMD (femoral neck: β : –0.039; 95% CI: −0.142 to 0.063; lumbar spine: β : −0.041; 95% CI: −0.182 to 0.101), though not statistically significant. No causal relationship was found with sleep duration. Conclusions: Sleep disorders may be causally associated with a higher risk of bone loss. Extending sleep duration does not appear to compensate for sleep disorder-related bone loss.