Bone turnover is altered during 72 h of sleep restriction: a controlled laboratory study

Endocrine. 2019 Jul;65(1):192-199. doi: 10.1007/s12020-019-01937-6. Epub 2019 Apr 26.


Purpose: The objective of the study was to evaluate how controlled, short-term sleep restriction (SR; 72 h) alters markers of bone formation and resorption and urinary calcium (Ca) output.

Methods: Ten healthy, sleep-adequate, male soldiers were housed in the research facility one day prior to and for the duration of SR. Diet was controlled to provide adequate energy balance and macronutrient distribution, meeting the recommended dietary allowance (RDA) for Ca. Subjects engaged in light activities to maintain wakefulness and were allowed 2 h of sleep per night (0430-0630 hours). Blood samples were collected each morning at 0 h (baseline) and 24, 48, and 72 h of SR. Serum was assayed for parathyroid hormone (PTH), bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRAP), and C-terminal telopeptide of type I collagen (CTX). Urine was collected in 24 h increments during SR for measurement of Ca and creatinine (Cr).

Results: BAP was reduced at 24 h (P= 0.015) and resorption markers TRAP and CTX were increased after 48 and 72 h of SR compared to baseline (P < 0.05). The ratio of BAP:TRAP was significantly lower (P= 0.017) at 48 and 72 h of SR. In contrast, total 24 h urinary Ca and Ca/Cr excretion were unchanged.

Conclusions: Markers of bone formation and resorption are uncoupled in response to as little as 48 h of SR even when Ca intake is at the RDA. Sleep deprivation may be a risk factor for reduced bone health due to perturbations in bone turnover.

Keywords: Biomarker; Bone turnover; Military; Sleep deprivation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alkaline Phosphatase / blood
  • Biomarkers / blood
  • Bone Density / physiology
  • Bone Remodeling / physiology*
  • Bone Resorption / blood
  • Bone Resorption / metabolism
  • Bone Resorption / physiopathology
  • Calcium / blood
  • Case-Control Studies
  • Collagen Type I / blood
  • Humans
  • Male
  • Osteocalcin / blood
  • Parathyroid Hormone / blood
  • Sleep / physiology
  • Sleep Deprivation / blood
  • Sleep Deprivation / metabolism
  • Sleep Deprivation / physiopathology*
  • Time Factors
  • Young Adult


  • Biomarkers
  • Collagen Type I
  • Parathyroid Hormone
  • Osteocalcin
  • Alkaline Phosphatase
  • Calcium