Researchers at WashU Medicine found that adults who regularly experience short or poor-quality sleep, as well as those who work night shifts, face a significantly higher risk of developing osteoarthritis and requiring hip or knee replacement surgery.
Led by Elizabeth Yanik, an assistant professor in the WashU Medicine Department of Orthopaedic Surgery, the study analyzed health data from nearly 500,000 participants enrolled in the UK Biobank, a large-scale biomedical database available for research. The findings, published in Arthritis Care & Research, suggest that sleep health may play an important role in joint health along with traditional risk factors such as age, obesity and prior joint injury.
Participants who slept fewer than six hours per night or frequently reported difficulty falling or staying asleep had a 20-40% higher risk of hip or knee osteoarthritis compared to those who slept about seven hours. Surveys have found that 17% of Americans over age 50 have osteoarthritis in the hip, and 14% of all U.S. adults have symptomatic osteoarthritis in the knee.
Night shift workers had a 24% higher risk of knee osteoarthritis and 28% percent higher risk of having a total knee replacement compared to people who didn’t work night shifts, an association that remained even after accounting for body weight and other health factors. The relationship was stronger for the knee than the hip, suggesting that circadian rhythms may affect joints differently.
The findings add to growing evidence that sleep and circadian rhythms influence inflammation, tissue repair and pain sensitivity, all of which may contribute to osteoarthritis development. The associations were observed even among participants without chronic joint pain at baseline, suggesting that poor sleep may contribute to osteoarthritis, rather than result from it. The research highlights sleep as a potentially modifiable factor that could be addressed alongside physical activity, weight management and injury prevention to help reduce osteoarthritis risk and delay the need for joint replacement.
