Osteoporosis International

, Volume 29, Issue 8, pp 1689–1695 | Cite as

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

  • D. Wang
  • W. Ruan
  • Y. Peng
  • W. LiEmail author


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.


Dose-response Meta-analysis Osteoporosis Sleep duration 



This work was funded by the China Postdoctoral Science Foundation funded project (2017M622466). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflicts of interest


Supplementary material

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Fig. S1

Dose-response relationship plot between long sleep duration and risk of osteoporosis (JPEG 38.1 KB)

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Dose-response relationship plot between short sleep duration and risk of osteoporosis (JPEG 42.8 KB)

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Fig. S3

Begg’s funnel plot for studies of long sleep duration in relation to osteoporosis risk (JPEG 59.7 KB)

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Fig. S4

Begg’s funnel plot for studies of short sleep duration in relation to osteoporosis risk (JPEG 59.8 KB)

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Fig. S5

Sensitivity analysis plot to evaluate the effect of each study on the overall long sleep duration and osteoporosis risk (JPEG 74.0 KB)

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Fig. S6

Sensitivity analysis plot to evaluate the effect of each study on the overall short sleep duration and osteoporosis risk (JPEG 65.7 KB)

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  1. 1.Department of Occupational & Environmental Health, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Wuhan Prevention and Treatment Center for Occupational DiseasesWuhanPeople’s Republic of China
  3. 3.Department of Clinical MedicineXi’an Medical UniversityXi’anPeople’s Republic of China
  4. 4.Department of EmergencyWuhan Center for Diseases Prevention and ControlWuhanPeople’s Republic of China
  5. 5.Department of Social Medicine and Health Management, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China

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