Poor sleep behaviors and high genetic susceptibility increase the risk of osteoarthritis

Abstract Background Emerging research evidence suggests an association between sleep behaviors and the risk of osteoarthritis. The various sleep behaviors are typically correlated; however, most previous studies have focused on a particular sleep behavior without considering the overall sleep pattern. Combining conventional evidence from UK Biobank longitudinal data and genetic evidence from Mendelian randomization methods to infer causality between sleep behaviors and osteoarthritis (OA) at different sites. Method First, we conducted an assessment of the association between various sleep behaviors and different OA sites based on the comprehensive prospective cohort study of the UK Biobank. Furthermore, we constructed individual sleep risk scores (ISRS) to evaluate their effect on OA when combined. Second, we utilized MR to provide genetic evidence for the causal linkage between sleep behavior and OA. Finally, we calculated a genetic risk score (GRS) for OA based on a large-scale genome-wide association study and assessed the joint effect of sleep and genetic factors on the risk of OA. Results We found a U-shaped relationship between sleep duration and the risk of OA ( P nonlinear < 0.001), with the lowest risk for sleep duration of 7–8 hours per day. Participants with often and sometimes insomnia had a 46.9% and 16.4% increased risk of OA (HR Sometimes = 1.164, 95% CI = 1.132∼1.197, P Sometimes = 3.44×10 − 26 ; HR Usually =1.469, 95% CI = 1.426∼1.514, P Usually =3.82×10 − 142 ), respectively, while MR analysis also provided consistent evidence. Similar results were observed in participants who were daytime dozing, but no association between daytime dozing and risk of OA was shown in the MR analysis. In observational studies, snoring and difficulty getting up are associated with an increased risk of OA. We further constructed ISRS with potential risk sleep factors. We found that the risk of OA was positively associated with ISRS; furthermore, if all participants maintained healthy sleep behavior, 21.3% of OA cases could be removed. Conclusion Unhealthy sleep behaviors, individually or in combination, could increase the risk of OA, while poor sleep behaviors and genetic factors can collaboratively increase the risk of OA.