Sleep characteristics and intervertebral disc degeneration risk: an observational and Mendelian randomization study

doi:10.1007/s00586-025-08669-4

Observational Study

. 2025 May;34(5):1685-1696.

doi: 10.1007/s00586-025-08669-4. Epub 2025 Jan 27.

Sleep characteristics and intervertebral disc degeneration risk: an observational and Mendelian randomization study

Shiyong Zhang^#^{1

2

3}, Zixin Liang^#², Yanlin Zhong^#³, Qingfeng Luo⁴, Danni Wang⁵, Bin Xia², Xudong Wang³, Yunze Kang³, Zijian Zhou¹, Puyi Sheng³, Jinqiu Yuan^{6

7

8}, Ziji Zhang⁹, Fuxin Wei¹⁰

Affiliations

¹ Department of Orthopedics, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China.
² Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China.
³ Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
⁴ Chongqing Municipality Clinical Research Center for Geriatrics, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
⁶ Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁷ Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁸ Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁹ Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China. zhangziji@mail.sysu.edu.cn.
¹⁰ Department of Orthopedics, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. weifuxin@mail.sysu.edu.cn.

^# Contributed equally.

PMID: 39865174
DOI: 10.1007/s00586-025-08669-4

Observational Study

Sleep characteristics and intervertebral disc degeneration risk: an observational and Mendelian randomization study

Shiyong Zhang et al. Eur Spine J. 2025 May.

. 2025 May;34(5):1685-1696.

doi: 10.1007/s00586-025-08669-4. Epub 2025 Jan 27.

Authors

Affiliations

¹ Department of Orthopedics, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China.
² Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China.
³ Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
⁴ Chongqing Municipality Clinical Research Center for Geriatrics, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
⁶ Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁷ Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁸ Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. yuanjq5@mail.sysu.edu.cn.
⁹ Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China. zhangziji@mail.sysu.edu.cn.
¹⁰ Department of Orthopedics, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, Guangdong, China. weifuxin@mail.sysu.edu.cn.

^# Contributed equally.

PMID: 39865174
DOI: 10.1007/s00586-025-08669-4

Abstract

Objectives: Sleep disorders are considered a risk factor for aging and skeletal degeneration, but their impact on intervertebral disc degeneration (IDD) remains unclear. The aim of this study was to assess associations between sleep characteristics and IDD, and to identify potential causal relationships.

Methods: Exposure factors included six unhealthy sleep characteristics: insomnia, short sleep duration (< 7 h), long sleep duration (≥ 9 h), evening chronotype, daytime sleepiness, and snoring. The primary outcomes included cervical disc degeneration (CDD) and lumbar disc degeneration (LDD). Firstly, we examined the associations between sleep characteristics and IDD risk in 368,348 participants from the UK Biobank using Cox proportional hazards model. Two-sample Mendelian randomization (MR) analyses were conducted to validate associations found in observational analyses, using genome-wide association data from the UK Biobank and FinnGen consortia.

Results: During a median follow-up time of 13.8 years, a total of 1,637 cases of CDD and 7,654 cases of LDD were identified. Observational analyses found that almost all unhealthy sleep characteristics were associated with an elevated risk of IDD, except snoring. Conversely, the risk of IDD decreased linearly with an increasing number of healthy sleep characteristics. MR analyses supported a causal association between genetically determined insomnia and increased risk of LDD (OR 1.25 [1.07-1.47]), and between short sleep duration and increased risk of both IDD phenotypes (OR 5.41 [1.95-15.01] for CDD; OR 3.48 [1.76-6.89] for LDD). However, long sleep duration was causally associated with a reduced risk of LDD (OR 0.13 [0.03-0.53]), which contrasts with the observational findings.

Conclusion: We found associations between multiple sleep characteristics and IDD risk and confirmed that insomnia and short sleep duration increased IDD risk. Although more research is needed to confirm the underlying mechanisms, prioritizing interventions to improve sleep quality and ensure adequate sleep could help mitigate IDD.

Keywords: Intervertebral disc degeneration (IDD); Mendelian randomization (MR); Observational study; Sleep characteristics; The UK Biobank.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interest: The authors declared that no competing interests exist. Ethics statement: This study was approved by the North West Multi-center Research Ethics Committee, the England and Wales Patient Information Advisory Group, and the Scottish Community Health Index Advisory Group (application number 51671, 71986). All participants provided written informed consent prior to data collection.

References

1. Novais EJ, Narayanan R, Canseco JA et al (2024) A new perspective on intervertebral disc calcification-from bench to bedside[J]. Bone Res 12(1):3. https://doi.org/10.1038/s41413-023-00307-3 - DOI - PubMed - PMC
1. Jin Z, Wang D, Zhang H et al. Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017[J]. Ann Rheum Dis, 2020 79(8):1014–1022. https://doi.org/10.1136/annrheumdis-2020-217050
1. Costachescu B, Niculescu AG, Teleanu RI et al (2022) Recent advances in managing spinal intervertebral discs Degeneration[J]. Int J Mol Sci 23(12). https://doi.org/10.3390/ijms23126460
1. Wang F, Cai F, Shi R et al (2016) Aging and age related stresses: a senescence mechanism of intervertebral disc degeneration[J]. Osteoarthritis Cartilage 24(3):398–408. https://doi.org/10.1016/j.joca.2015.09.019 - DOI - PubMed
1. Guan SY, Zheng JX, Sam NB et al (2023) Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019[J]. Autoimmun Rev 22(8):103361. https://doi.org/10.1016/j.autrev.2023.103361 - DOI - PubMed

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[1] Novais EJ, Narayanan R, Canseco JA et al (2024) A new perspective on intervertebral disc calcification-from bench to bedside[J]. Bone Res 12(1):3. https://doi.org/10.1038/s41413-023-00307-3 - DOI - PubMed - PMC

[2] Novais EJ, Narayanan R, Canseco JA et al (2024) A new perspective on intervertebral disc calcification-from bench to bedside[J]. Bone Res 12(1):3. https://doi.org/10.1038/s41413-023-00307-3 - DOI - PubMed - PMC

[3] Jin Z, Wang D, Zhang H et al. Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017[J]. Ann Rheum Dis, 2020 79(8):1014–1022. https://doi.org/10.1136/annrheumdis-2020-217050

[4] Jin Z, Wang D, Zhang H et al. Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017[J]. Ann Rheum Dis, 2020 79(8):1014–1022. https://doi.org/10.1136/annrheumdis-2020-217050

[5] Costachescu B, Niculescu AG, Teleanu RI et al (2022) Recent advances in managing spinal intervertebral discs Degeneration[J]. Int J Mol Sci 23(12). https://doi.org/10.3390/ijms23126460

[6] Costachescu B, Niculescu AG, Teleanu RI et al (2022) Recent advances in managing spinal intervertebral discs Degeneration[J]. Int J Mol Sci 23(12). https://doi.org/10.3390/ijms23126460

[7] Wang F, Cai F, Shi R et al (2016) Aging and age related stresses: a senescence mechanism of intervertebral disc degeneration[J]. Osteoarthritis Cartilage 24(3):398–408. https://doi.org/10.1016/j.joca.2015.09.019 - DOI - PubMed

[8] Wang F, Cai F, Shi R et al (2016) Aging and age related stresses: a senescence mechanism of intervertebral disc degeneration[J]. Osteoarthritis Cartilage 24(3):398–408. https://doi.org/10.1016/j.joca.2015.09.019 - DOI - PubMed

[9] Guan SY, Zheng JX, Sam NB et al (2023) Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019[J]. Autoimmun Rev 22(8):103361. https://doi.org/10.1016/j.autrev.2023.103361 - DOI - PubMed

[10] Guan SY, Zheng JX, Sam NB et al (2023) Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019[J]. Autoimmun Rev 22(8):103361. https://doi.org/10.1016/j.autrev.2023.103361 - DOI - PubMed

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Sleep characteristics and intervertebral disc degeneration risk: an observational and Mendelian randomization study

Affiliations

Sleep characteristics and intervertebral disc degeneration risk: an observational and Mendelian randomization study

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