Self-Reported Sleep Disturbances over the Menopausal Transition and Fracture Risk: The Study of Women's Health Across...

Area of Science:

• Bone and Mineral Research
• Sleep Medicine
• Epidemiology

Background:

• Sleep disturbances are prevalent and may influence fracture risk through various mechanisms.
• The menopausal transition (MT) is a period of significant physiological change that can affect both sleep and bone health.

Purpose of the Study:

• To investigate the prospective association between self-reported sleep disturbances during the menopausal transition and the risk of fractures.

Main Methods:

• Prospective cohort study of 3101 women in the Study of Women's Health Across the Nation (SWAN).
• Sleep disturbances (trouble falling asleep, nighttime awakenings, early morning awakenings) assessed at 14 visits over time.
• Time-varying exposures modeled, adjusting for numerous covariates including age, BMI, MT stage, lifestyle factors, and medications.

Main Results:

• Women with fractures reported more frequent sleep disturbances at baseline (35% vs. 30%).
• In unadjusted models, any sleep disturbance (OR=1.23) and nighttime awakenings (OR=1.36) were associated with increased fracture risk.
• These associations were attenuated to nonsignificance after full adjustment for confounding factors.

Conclusions:

• Self-reported sleep disturbances during the menopausal transition are associated with an increased risk of fractures.
• The observed associations are likely mediated by shared risk factors or other factors within the causal pathway, not a direct effect of sleep disturbances on fracture risk.
• Further investigation into shared risk factors is warranted to elucidate the relationship between sleep disturbances and bone health.