New Study Uncovers Sleep Apnea and Osteoporosis Link

Previous research showed that untreated sleep apnea can lead to a number of potentially dangerous health problems including heart disease, heart attack, stroke, high blood pressure, heart failure, diabetes and depression. A new retrospective cohort study published in the Journal of Clinical Endocrinology & Metabolism found that women and older people with sleep apnea may have an increased risk of developing bone-thinning osteoporosis.

Oxygen Deprivation Weakens Bones

from Chi Mei Medical Center in Tainan and Kaohsiung Chang Gung Memorial Hospital in Kaohsiung, Taiwan, used medical records to track the treatment of 1377 patients who received obstructive sleep apnea diagnoses between 2000 and 2008. During the next six years, they compared osteoporosis diagnoses rates to 20,655 people of comparable age and gender who didn’t have the common sleep disorder. Sleep apnea causes repeated, brief breathing interruptions during sleep. Obstructive sleep apnea (OSA), the most common form, occurs during airway blockage. The study team concluded that ongoing periodic oxygen deprivation can harm the skeletal system and weaken bones. After adjusting for age, gender, other medical problems, geographic location and monthly income, people suffering from sleep apnea were 2.7 times more likely to receive an osteoporosis diagnosis during the six-year follow-up period. The risk was highest among women and older people with sleep apnea. This progressive condition can lead to bone fractures, reduced quality of life and death. The study found an association between sleep apnea and osteoporosis but didn’t prove that one causes the other. Study co-author Dr. Kai-Jen Tien of Chi Mei Medical Center advises that sleep apnea patients need to be more aware of their heightened risk of developing osteoporosis. Working with your doctor, monitor your bone health closely to catch and treat complications as early as possible.

Other Osteoporosis Risk Factors

According to the , these fixed risk factors determine that you have a heightened chance of developing osteoporosis.

• Age. Ninety percent of hip fractures occur in people aged 50 and older, partly because bone mineral density reduces as you age. But older adults without osteoporosis have higher fall risks, so they’re also are more likely to suffer fractures than younger people.
• Female gender. Women are more susceptible to bone loss than men. After menopause, their bodies produce less estrogen. This hormone is an important component in bone formation. Women also are more likely to sustain osteoporotic fractures than men. Lifetime fracture risks are 40-50 percent for women to 13-22 percent for men.
• Family history. A birth parent who had fracture(s) increases your bone breakage risk.
• Ethnicity. Studies have found that osteoporosis is more common in Caucasian and Asian populations. Hip and spine fracture incidence is higher in whites than African-Americans.
• Previous fracture. If you had a previous bone breakage, your risk of a repeat fracture goes up by 86 percent.
• Menopause or hysterectomy. Estrogen loss after menopause or a hysterectomy with ovary removal may increase your osteoporosis risk.

Secondary risk factors are less prevalent, but they can have significant impacts on bone health and fracture incidence. Some diseases affect bone remodeling directly or indirectly. Certain conditions influence your mobility and balance, which can contribute to increased risk of falling and sustaining fractures.

• Asthma
• Nutritional and gastrointestinal problems (Crohn’s and celiac diseases)
• Rheumatoid arthritis
• Hematological disorders and malignancy
• Some inherited disorders
• Endocrine disorders (hyperparathyroidism and diabetes)
• Immobility

Sleep Apnea Management

Obstructive sleep apnea treatment depends in part on the severity of your sleep-disordered breathing (SDB). People with mild apnea have a variety of options. General and behavioral measures include weight loss, not drinking alcohol for four to six hours before bedtime and sleeping on your side instead of on your stomach or back. If you suffer from moderate to severe OSA, nasal continuous positive airway pressure (CPAP) therapy may be necessary to manage your symptoms.

Osteoporosis Treatment Options

Raloxifene is a selective estrogen receptor modulator (SERM) that reduces two common risks post-menopausal women face. It copies the effects of estrogen to help increase bone density and prevent osteoporosis. That will make you less susceptible to fractures and other types of injuries. As a bonus, Raloxifene also stops estrogen’s effects on breast tissue that could lead to cancer. Risedronate is a bisphosphonate that’s appropriate for both men and women. It increases bone density and lowers your risks of spine and hip fractures, even if you’ve experienced prior bone breakage. Eve Scopelitis, M.D., an internist at Ochsner Medical Center in New Orleans, La., advises that taking adequate calcium and vitamin D with your prescription osteoporosis medicine is crucial. Vitamin D promotes optimal calcium absorption and bone health. Eating a healthy diet, limiting alcohol and caffeine consumption, not smoking and doing weight-bearing exercises also help slow bone loss.

Home Safety Tips

Because osteoporotic bones are fragile, they can break easily. Most fractures occur at home. Follow the National Osteoporosis Foundation’s fall prevention guidelines to avoid injuries.

• Floors. Remove loose wires, cords and clutter. Anchor rugs. Keep furniture in customary places.
• Lighting. Provide adequate entry, hall and stairway lighting. Turn on lights if you get up during the night. Use bathroom nightlights.
• Bathrooms. Install grab bars and non-slip floor stickers in tubs and showers.
• Kitchen. Place non-skid rubber mats in front of your sink and stove. Clean spills immediately.
• Stairs. Secure rails, treads and rugs.