Associations of Sleep and Shift Work With Osteoarthritis Risk

OBJECTIVE: Daily rhythms may be critical for maintaining homeostasis of joint tissues. We aimed to investigate the relationships among circadian clock disruption, sleep, and osteoarthritis (OA) risk in humans. METHODS: In the UK Biobank, a prospective 500,000-person cohort, we evaluated associations among sleep duration, sleeplessness/insomnia, and shift work type with four endpoints: knee OA, hip OA, total knee arthroplasty (TKA), and total hip arthroplasty. Cox regression was used to estimate associations with OA endpoints adjusting for age, sex, education, race, Townsend Deprivation Index, manual work frequency, and frequency of occupational walking/standing. Associations with and without adjustment for body mass index were estimated, as circadian clock disruption may influence OA through effects on obesity. RESULTS: For all OA endpoints, risk was highest among those getting