# Bone Turnover Responses to Sleep Restriction and Subsequent Sleep Recovery

> **NIH NIH R03** · UNIVERSITY OF COLORADO DENVER · 2020 · $77,750

## Abstract

PROJECT SUMMARY
Sleep and circadian disruptions negatively impact many biological systems and may represent novel,
modifiable risk factors for low bone mass and fracture. We were the first to report that cumulative sleep
restriction with concurrent circadian disruption (akin to rotating shift work) suppressed a marker of bone
formation but not resorption in healthy men. These data parallel those from sleep restriction studies in animals
where lower bone mineral density (BMD) compared to controls was also observed. This uncoupling of bone
turnover markers (BTMs) in humans may limit attainment of peak bone mass if sleep and circadian disruption
occur in adolescence or early adulthood during bone modeling and consolidation, and may accelerate bone
loss when experienced later (e.g. during the menopausal transition, when sleep disturbance is common). My
K23 data have demonstrated that combined sleep restriction and circadian disruption induce similar BTM
changes in women and that these changes occur within a few days of exposure to the combined sleep and
circadian disturbance. The effects of insufficient sleep duration, without extreme circadian disruption, on BTMs,
independent of the inpatient laboratory environment and inherent physical inactivity, and the ability to reverse
or improve BTM impairments with recovery sleep are unknown. The overall scientific objectives of this R03
application are to evaluate the effects of insufficient sleep duration, without extreme circadian disruption, on
BTMs in women and men, independent of physical inactivity, and the role of recovery sleep to stabilize BTMs
or compensate for the period of shortened sleep. The central hypothesis is that insufficient sleep duration,
independent of relative physical inactivity, will impair a marker of bone formation (P1NP) in women and men
with no change in a marker of bone resorption (CTX), and that extending sleep duration will restore P1NP
levels to baseline. These novel pilot data will provide a critical extension to my K23 to generate innovative
hypotheses with significant clinical impact that I can test in my R01 - a comprehensive investigation of the
mechanisms by which sleep and circadian disruption alter bone health in humans. The specific aims are:
 1. Investigate if insufficient sleep duration during the work week decreases a marker of bone formation
 without altering a bone resorption marker.
 2. Establish that insufficient sleep induces changes in bone biomarkers independent of physical inactivity
 inherent in an inpatient lab study, by comparing BTM changes in sleep-restricted participants to controls.
 3. Determine if extending sleep for a weekend or 3 weeks can improve or reverse impairments in bone
 metabolism induced by sleep restriction.
This research will have a sustained and powerful influence on science and patient care because it can
introduce a paradigm shift in osteoporosis prevention, evaluation, and treatment.

## Key facts

- **NIH application ID:** 9873496
- **Project number:** 1R03AR074509-01A1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Christine M Swanson
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $77,750
- **Award type:** 1
- **Project period:** 2020-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9873496

## Citation

> US National Institutes of Health, RePORTER application 9873496, Bone Turnover Responses to Sleep Restriction and Subsequent Sleep Recovery (1R03AR074509-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9873496. Licensed CC0.

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