Association between sleep duration, sleep apnea risk, and osteoporosis in older adults: a cross-sectional study in elder care institutions in Taiwan

Background: This study investigated the relationship between sleep disturbance, obstructive sleep apnea (OSA), and osteoporosis in older adults. Methods: This cross-sectional study involved 326 older adults (mean age: 83.46 years) in elder care institutions in Taiwan. The presence of osteoporosis was assessed using dual-energy X-ray absorptiometry, while sleep quality and OSA risk were evaluated using the Pittsburgh Sleep Quality Index and STOP-Bang questionnaire, respectively. Heart rate variability (HRV) was measured to assess autonomic function. Logistic regression models, adjusted for age, body mass index (BMI), and comorbidities, were used to examine the associations among sleep duration, OSA risk, and osteoporosis. Results: Osteoporosis was more prevalent in females and those with lower BMI and neck circumference, and less common in individuals with knee osteoarthritis. Intermediate-to-high OSA risk was associated with the male sex, higher BMI, higher neck circumference, and cardiovascular comorbidities. Short sleep duration (< 4 h) was initially correlated with a higher osteoporosis risk, but this association disappeared after adjusting for covariates. However, after adjusting for covariates, intermediate-to-high OSA risk was significantly associated with osteoporosis. HRV showed no significant difference in assessing osteoporosis or OSA risk in this study. Conclusion: Short sleep duration (< 4 h) and intermediate-to-high OSA risk were associated with a higher prevalence of osteoporosis among older adult participants, compared to those with 6–7 h of sleep or low OSA risk. Further research is required to explore the relationship between sleep and osteoporosis in older adults.