The association between obstructive sleep apnea and osteoporosis: A systematic review and meta-analysis

• Published in: Sleep medicine reviews 2024-12, Vol.78, p.102006, Article 102006
• Main Authors: Chan, Yong Hoe, Teo, Chong Boon, Tay, Joshua K., Cheong, Crystal S.
• Format: Article
• Language: English
• Subjects: Body Mass Index; Bone Density; Bone health; Bone mineral density; Humans; Metabolic bone disease; Obstructive sleep apnea; Osteoporosis; Risk Factors; Sleep apnea; Sleep apnea syndrome; Sleep Apnea, Obstructive - complications; Sleep disordered breathing
• ISSN: 1087-0792; 1532-2955; 1532-2955
• DOI: 10.1016/j.smrv.2024.102006

Obstructive sleep apnea (OSA) is a sleep disorder with well-known metabolic consequences. The relationship between OSA and bone health, especially osteoporosis, remains poorly understood. Given that both OSA and osteoporosis are highly prevalent chronic conditions with significant public health implications, this study aims to investigate the association of OSA with bone health and osteoporosis. A systematic search of PubMed, Embase and Cochrane Library was conducted from inception to November 22, 2022. Fifteen studies comprising 158,273 individuals were included. The presence of OSA correlated negatively with bone mineral density on meta-analysis (pooled correlation = -0.30; 95 % CI, -0.42 to -0.17; N = 8). Individuals with OSA had poorer bone mineral density scores (mean difference = -0.58, 95 % CI, -1.15 to -0.01; N = 8), and significantly higher risk of developing osteoporosis (adjusted odds ratio = 2.18; 95 % CI, 1.14 to 4.16; N = 4). Notably, both body mass index (BMI) and age were not significant effect modulators in the correlation of OSA and bone density. These findings suggest that OSA is associated with diminished bone health, and it is severity-dependent. Further studies are required to determine if treatment of OSA may have the potential to mitigate these risks.