"Getting five or fewer hours of sleep a night is associated with low bone mineral density (BMD) and higher odds of osteoporosis, according to the findings of the largest study of sleep and BMD to date among U.S. postmenopausal women." When I came across this statement, I recognized a need to examine my sleep patterns, sleep hygiene (as referred to in physical therapy), and lifestyle.
This statement is derived from an article from the University of Buffalo, with the link provided at the end.
I entered menopause without osteopenia or osteoporosis, but my DEXA scan revealed a T-score closer to -1.4 (osteopenia) and -2.5 (osteoporosis) than I would have preferred. My knowledge of menopause indicated that women can lose up to 20% of their bone density during the menopause transition, lasting up to 7 years after the onset of menopause, defined as the absence of a menstrual cycle for 12 consecutive months. So naturally, when I saw the above mentioned article, I started looking at my own sleep (and lack there of).
Sleep Patterns
Understanding sleep patterns involves cycling through two phases of sleep: rapid eye movement (REM) and non-REM sleep, which includes deep and light sleep. Keeping a tracking log for a few weeks, noting bedtime, waking time, instances of waking during the night, and their duration, can provide valuable insights. Utilizing a smartwatch for tracking sleep duration, sleep phases, and awake minutes at night can be beneficial. Once aware of sleep habits, adjustments can be made, considering factors like diet, exercise, and lifestyle choices. Consulting with a healthcare provider, such as a physical therapist, may also aid in formulating a personalized plan.
Quality of life matters. Worry and confusion often follow a diagnosis of osteoporosis. Body In Tune, LLC recognizes that each client is unique and aims to answer your top questions about yoga and osteoporosis, women’s health and the advantages of physical therapy among other things.
Sleep Hygiene
Sleep hygiene, defined by Oxford Languages as "habits and practices conducive to sleeping well on a regular basis," plays a crucial role. In physical therapy, we often emphasize the importance of bedtime routines in achieving good sleep. Poor sleep not only affects bone density but also influences weight management, cardiovascular health, and diabetes. Lifestyle changes, such as creating time for 7-8 hours of sleep, maintaining a consistent sleep schedule (sleep and wake times), avoiding technology an hour before bed, dimming lights in the evening as bedtime nears, limiting the intake of fluids starting 2 hours before bed (to minimize waking due to a full bladder) contribute to improved sleep hygiene. These are habits we may need to practice.
Establishing habits is similar to training one's bladder to NOT wake you up in the middle of the night. It starts when you wake during a cycle of light sleep and thinking while I’m awake, I’ll just use the restroom. If we practice this repeatedly, the brain can learn to wake us a specific times. To un-train the brain, try practicing actions like delaying a visit to the restroom for 5 minutes. If your bladder is really what woke you up, you will not fall back asleep and then you can respond appropriately. Side note - Seeking out a women’s and pelvic health physical therapist can also be of assistance.
In case you are curious Body in Tune would love to collaborate with you to design a sleep hygiene practice that fits your life.
Sleep Quality
Sleep quality is a measure of how well one sleeps, and may be influenced by lifestyle factors and stress and anxiety. Yoga, particularly restorative postures and breathing practices, may help with the latter and improve sleep quality. Restorative poses like child's pose, constructive rest, or legs up the wall, combined with mindful breathing, offer potential benefits such as relaxation, easing stress, improved sleep patterns, and relief from various discomforts. If you have osteoporosis, you may want to meet with a professional trained in yoga for osteoporosis so you can be mindful of how you transition in and out of these positions to protect your spine from injury. Also an article from the Cleveland Clinic warns that people with glaucoma, high blood pressure and fluid retention should speak with their physician before trying legs up the wall.
A breathing practice, especially before bed or during nighttime wakefulness, can calm a racing mind. Using an asymmetrical breath, inhaling for 3-4 counts and exhaling for 6-8 counts, helps redirect focus and promote relaxation. It sounds similar the “counting sheep”.
Lastly, regular exercise, specifically 30 minutes of moderate aerobic activity, has been shown to facilitate faster sleep onset and improve overall sleep quality. Johns Hopkins Medicine recommends avoiding exercise 1-2 hours before bed to allow the endorphins levels time to wash out and the “brain time to wind down”. According to the Centers for Disease Control and Prevention examples of moderate exercise include walking, hiking or activity during which you can talk but not sing.
When it comes to maintaining or slowing the loss of bone density with osteoporosis, I encourage you to do an assessment of your sleep patterns, sleep hygiene and sleep quality. There are many things in life over which we have little or no control, but there are practices to help us reap the benefits of better sleep that can be within our control.
Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.
I would welcome the opportunity to be part of your support team with regards to your sleep patterns, hygiene and quality so you can make the subtle lifestyle changes to support and protect your bone health. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.
Source:
Getting a Good Nights Rest is Important for Better Bone Health https://www.buffalo.edu/ubnow/stories/2019/11/ochs-balcom-sleep-bmd.html