The relationship between healthy sleep patterns and the risk of scoliosis: a large prospective cohort study

Currently, prospective evidence on how sleep habits specifically affect scoliosis is nearly nonexistent. We therefore sought to clarify the association between comprehensive sleep behavior patterns and the incidence of this disease.

This study conducted a prospective cohort study based on the UK Biobank (UKB), including 408,870 participants who did not have scoliosis at baseline. We have constructed a comprehensive sleep scoring system that integrates the following five key indicators: sleep chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. To evaluate the association between healthy sleep patterns and the risk of scoliosis, we conducted a statistical analysis using the Cox proportional hazards regression model.

Over a mean follow-up of 15.82 years, 2,976 incident cases of scoliosis were recorded (0.73%). The 408,870 participants who were free of scoliosis at baseline had a mean age of 56.48 years. Distribution of the healthy sleep score was as follows: 9,939 participants (2.43%) had 0-1 of the five healthy sleep behaviors, 46,175 (11.29%) had 2 behaviors, 115,094 (28.15%) had 3 behaviors, 150,287 (36.76%) had 4 behaviors, and 87,375 (21.37%) had all five. In multivariable models, each 1-point increase in the healthy sleep score was associated with a 10% lower risk of scoliosis [hazard ratio (HR) = 0.90; 95% confidence interval (CI) = 0.87, 0.93]. Compared with the 0-1 score group, the multivariable-adjusted HR (95% CI) for participants with a score of 5 was 0.64 (0.52, 0.80). In subgroup analyses, the inverse association between sleep score and scoliosis risk persisted among participants without diabetes but was absent among those with diabetes (p _interaction < 0.05).

Cohort analysis results confirm that adherence to a healthy sleep-behavior pattern significantly reduces the risk of scoliosis.