Obstructive Sleep Apnea and Risk for Incident Vertebral and Hip Fracture in Women

ABSTRACTRecent studies suggest a positive association between obstructive sleep apnea (OSA), a disorder associated with intermittent hypoxia and sleep fragmentation, and derangements in bone metabolism. However, no prospective study to date has investigated the association between OSA and fracture risk in women. We conducted a prospective study examining the relation between OSA and risk of incident vertebral fracture (VF) and hip fracture (HF) in the Nurses' Health Study. History of physician ‐diagnosed OSA was assessed by self‐reported questionnaires. A previous validation study demonstrated high concordance between self‐reports and medical record identification of OSA. OSA severity was further categorized according to the presence or absence of self‐reported sleepiness. Self‐ reports of VF were confirmed by medical record review. Self‐reported HF was assessed by biennial questionnaires. Cox proportional‐hazards models estimated the hazard ratio for fracture according to OSA status, adjusted for potential confounders, including BMI, physical activity, calcium intake, history of osteoporosis, and falls, and use of sleep medications. Among 55,264 women without prior history of fracture, physician‐diagnosed OSA was self‐reported in 1.3% in 2002 and increased to 3.3% by 2012. Between 2002 and 2014, 461 incident VF cases and 921 incident HF cases were documented. The multivariable‐adjusted hazard ratio (HR) for confirmed VF for women with history of OSA was 2...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research