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Does sleep apnea impact your bone health? Let’s find out

Posted on March 26th, 2024

Sleep is a fundamental component of your well-being, and its importance extends far beyond feeling well-rested and alert. Over the years, research has revealed a connection between sleep and various facets of good health.

One interesting area that researchers are currently looking at is how obstructive sleep apnea (OSA) may be linked to early bone loss, a connection that could shed light on how nighttime breathing patterns may contribute to bone health.

Let’s take a closer look…

Understanding obstructive sleep apnea (OSA)

Obstructive sleep apnea is a disorder characterized by repetitive pauses in breathing during sleep, typically caused by the relaxation of the throat muscles. These pauses are known as apneas, and they can lead to fragmented sleep and diminished blood oxygen levels. OSA affects around 39 million people in the United States and is associated with a host of health concerns, including cardiovascular issues, cognitive impairment, and metabolic disorders.

Left untreated, OSA may lead to…

  • High blood pressure
  • Heart disease
  • Stroke
  • Diabetes
  • Depression
  • Memory problems
  • Weight gain
  • Headaches
  • Daytime fatigue and drowsiness

New research also shows that OSA may contribute to bone loss in older adults.

The surprising link between OSA and bone health

A recent study published in BMC Pulmonary Medicine uncovered a potential connection between OSA and early bone loss. This connection raises intriguing questions about the interplay between sleep, breathing patterns, and skeletal health. The study found that signs of early bone loss were higher in people with severe OSA compared to those with mild or moderate OSA, and compared to people without OSA.

The study involved 90 men aged 30-59, all of whom attended a sleep and respiratory center from August 2017 to February 2019. The participants’ average age was 47.1 years, and their average BMI was 25.7 kg/m2. Twenty-five of the participants had mild OSA. Twenty-one had moderate OSA. Thirty-four had severe OSA, and ten were controls. Researchers assessed participants’ bone health using advanced imaging and blood tests and by analyzing various bone parameters and density. 

Patients with severe OSA showed a significantly higher cortical area in the tibia compared to those with mild or moderate OSA. Bone mineral density was lower in OSA patients compared to controls without the condition. Significant differences were observed among OSA severity groups, and differences were also noted in bone microstructure, especially in trabecular and cortical thickness.

What are the mechanisms at play?

The precise mechanisms underlying this association are still being uncovered. However, several factors have been proposed. People with OSA often experience periods of low oxygen levels, which may disrupt the balance between bone formation and resorption, possibly leading to faster bone loss over time. Additionally, hormonal changes, inflammation, and oxidative stress, all of which are implicated in OSA, could further contribute to bone remodeling issues. 

Clinical implications and future directions

Recognizing OSA as a potential risk factor for early bone loss highlights the need for thorough sleep assessments in people with osteoporosis or those prone to bone-related issues. Incorporating assessments of sleep quality and breathing patterns into routine clinical practice could aid in early detection and intervention. These assessments might help reduce the harmful impacts of sleep apnea on bone health.

Furthermore, addressing OSA through therapeutic interventions such as continuous positive airway pressure (CPAP) therapy may reduce sleep-related symptoms. Doing so may also help preserve bone density and reduce the risk of osteoporotic fractures. However, additional research is needed to better understand the link between OSA and bone health and to find the best ways of managing bone issues in people with OSA.

Disorders like obstructive sleep apnea can have big effects on your body, including your bones. Scientists study connections between sleep and other health issues to find new ways of helping people with sleep problems to sleep better and make them live longer, healthier lives overall.

So, the next time you snuggle up for a good night’s sleep, remember – it’s not just your rest that’s at stake, but your bones and whole-body health!

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website:

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