Expert consensus on osteoporosis risk management in patients with sleep disorders
Siqi Leng , Jinming Yang , Yuming Jin , Jie Shi , Ye Zhang , Junying Zhou , Lu Tan , Taomei Li , Peiyan Ni , Kejia Hu , Yuan Shi , Jiamin Liao , Yun Li , Pei Xue , Christian Benedict , Alexandros N. Vgontzas , Michael Furian , Talant Sooronbaev , Naima Covassin , Virend K. Somers , Zhoulong Yu , Hongqiang Sun , Xiao Tan , Jihui Zhang , Yun Kwok Wing , Yue Leng , Larry D. Sanford , Michael V. Vitiello , Katie L. Stone , Rong Ren , Lin Lu , Xiangdong Tang
Bone Research ›› 2026, Vol. 14 ›› Issue (1) : 85
A rate-limiting step in the prevention and early intervention of osteoporosis is identifying its asymptomatic onset. Accumulating evidence shows that sleep disorders are associated with an increased risk of osteoporosis. Given their early detectable and modifiable nature, integrating sleep disorder management into osteoporosis prevention and care pathways offers a novel approach for enhancing skeletal health. This expert consensus represents a collaborative effort by specialists in sleep medicine and orthopedics from across the world, integrating epidemiological, mechanistic, and interventional evidence to provide general guidance for prevention and clinical practice, and to foster multidisciplinary collaboration in the management of sleep disorders and osteoporosis.
| [1] |
Consensus Development Conference Panel. Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. Am. J. Med.94, 646–650 (1993). |
| [2] |
|
| [3] |
|
| [4] |
|
| [5] |
Panahi, N. et al. Trend in global burden attributable to low bone mineral density in different WHO regions: 2000 and beyond, results from the Global Burden of Disease (GBD) study 2019. Endocr Connect. 12, e230160 (2023). |
| [6] |
|
| [7] |
|
| [8] |
|
| [9] |
|
| [10] |
|
| [11] |
|
| [12] |
|
| [13] |
|
| [14] |
|
| [15] |
|
| [16] |
|
| [17] |
|
| [18] |
|
| [19] |
|
| [20] |
|
| [21] |
|
| [22] |
|
| [23] |
|
| [24] |
|
| [25] |
|
| [26] |
|
| [27] |
|
| [28] |
|
| [29] |
|
| [30] |
|
| [31] |
|
| [32] |
|
| [33] |
|
| [34] |
|
| [35] |
|
| [36] |
|
| [37] |
|
| [38] |
|
| [39] |
|
| [40] |
|
| [41] |
|
| [42] |
|
| [43] |
|
| [44] |
Iantomasi, T. et al. Oxidative Stress and Inflammation in Osteoporosis: Molecular Mechanisms Involved and the Relationship with microRNAs. Int. J. Mol. Sci. 24, 3772 (2023). |
| [45] |
Wu, Q., Gao, G., Kwok, L. Y., Lv H. & Sun, Z. Insomnia: the gut microbiome connection, prospects for probiotic and postbiotic therapies, and future directions. J. Adv. Res. 82, 267–293 (2026). |
| [46] |
|
| [47] |
|
| [48] |
|
| [49] |
|
| [50] |
|
| [51] |
|
| [52] |
Wong, S. K., Chin, K. Y., Suhaimi, F. H., Ahmad, F., Ima-Nirwana, S. The relationship between metabolic syndrome and osteoporosis: a review. Nutrients8, 347 (2016). |
| [53] |
|
| [54] |
|
| [55] |
|
| [56] |
|
| [57] |
|
| [58] |
|
| [59] |
|
| [60] |
|
| [61] |
|
| [62] |
|
| [63] |
|
| [64] |
|
| [65] |
|
| [66] |
|
| [67] |
|
| [68] |
|
| [69] |
|
| [70] |
|
| [71] |
|
| [72] |
|
| [73] |
|
| [74] |
|
| [75] |
|
| [76] |
|
| [77] |
|
| [78] |
|
| [79] |
|
| [80] |
|
| [81] |
|
| [82] |
|
| [83] |
|
| [84] |
|
| [85] |
|
| [86] |
|
| [87] |
|
| [88] |
Vasey, C., McBride, J., Penta, K. Circadian rhythm dysregulation and restoration: the role of Melatonin. Nutrients. 13, 3480 (2021). |
| [89] |
|
| [90] |
|
| [91] |
|
| [92] |
Liu, P. Y. Rhythms in cortisol mediate sleep and circadian impacts on health. Sleep. 47, zsae151 (2024). |
| [93] |
|
| [94] |
|
| [95] |
|
| [96] |
|
| [97] |
|
| [98] |
|
| [99] |
|
| [100] |
|
| [101] |
|
| [102] |
|
| [103] |
|
| [104] |
|
| [105] |
|
| [106] |
|
| [107] |
Hardeland, R. Aging, Melatonin, and the pro- and anti-inflammatory networks. Int. J. Mol. Sci. 20, 1223 (2019). |
| [108] |
|
| [109] |
|
| [110] |
|
| [111] |
|
| [112] |
|
| [113] |
|
| [114] |
|
| [115] |
Petrov, M. E., Liu, L.Mudappathi, R., Whisner, C. M. Actigraphic sleep patterns are associated with bone turnover and bone mineral density among university students. J. Sleep Res. 33, e14192 (2024). |
| [116] |
|
| [117] |
Howe, T. E. et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst. Rev.2011, CD000333 (2011). |
| [118] |
|
| [119] |
|
| [120] |
|
| [121] |
|
| [122] |
|
| [123] |
|
| [124] |
|
| [125] |
|
| [126] |
|
| [127] |
|
| [128] |
|
| [129] |
|
| [130] |
|
| [131] |
|
| [132] |
|
| [133] |
|
| [134] |
Vilovic, M. et al. Bone metabolism parameters and inactive matrix Gla protein in patients with obstructive sleep apnea†. Sleep. 43, zsz243 (2019). |
| [135] |
|
| [136] |
|
| [137] |
|
| [138] |
Chen, W. et al. HIF-1α regulates bone homeostasis and angiogenesis, participating in the occurrence of bone metabolic diseases. Cells. 11, 3552 (2022). |
| [139] |
|
| [140] |
|
| [141] |
Korbecki, J. et al. Chronic and cycling hypoxia: drivers of cancer chronic inflammation through HIF-1 and NF-κB activation: a review of the molecular mechanisms. Int. J. Mol. Sci. 22, 10701 (2021). |
| [142] |
|
| [143] |
|
| [144] |
|
| [145] |
|
| [146] |
|
| [147] |
|
| [148] |
|
| [149] |
|
| [150] |
|
| [151] |
|
| [152] |
Meliante, P. G. et al. Molecular pathology, oxidative stress, and biomarkers in obstructive sleep apnea. Int. J. Mol. Sci. 24, 5478 (2023). |
| [153] |
Randerath, W. et al. European Respiratory Society guideline on non-CPAP therapies for obstructive sleep apnoea. Eur. Respir. Rev. 30, 210200 (2021). |
| [154] |
|
| [155] |
|
| [156] |
|
| [157] |
|
| [158] |
|
| [159] |
|
| [160] |
|
The Author(s)
/
| 〈 |
|
〉 |