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How stress and sleep affect bone health

When it comes to bone health, most of us immediately think of calcium, collagen and vitamin D.  We may even go as far as acknowledging the benefit of weight-bearing exercise. Whilst these factors are very important, two others are often overlooked when considering bone health.  Stress and poor sleep both have a negative impact on bone health. This blog explains why and gives some pointers as to how you can improve things.

The Impact of Stress on Bone Health

Stress is an emotional experience – but it is much more than this alone.  Stress has profound physiological effects. When we are stressed, our body releases the hormone cortisol which, in excess, can damage our bone health.

Cortisol & Bone Density

High levels of cortisol can lead to a decrease in bone density as cortisol interferes with the bone-building process. It inhibits the activity of osteoblasts (cells that create new bone) and promotes the activity of osteoclasts (cells that break down bone). If this happens over a period of time, the imbalance is likely to result in weaker bones and a higher risk of fractures.

Calcium Absorption

If the level of stress we are experiencing is very high, it can affect our digestive system and reduce our ability to absorb essential nutrients, including calcium. Calcium is critical for maintaining our bone density and strength; insufficient absorption will lead to a loss of bone density.


Stress can increase chronic inflammation throughout our body which has been linked to a variety of health issues, including osteoporosis. Inflammatory cytokines (small proteins important in cell signalling) can stimulate bone resorption, further weakening our bone structure.

The Role of Sleep in Bone Health

Sleep is another vital component of maintaining strong bones. During sleep, our body undergoes repair and regeneration including our bones.

Bone remodelling

This is the process in which old bone tissue is replaced by new tissue – which primarily occurs during sleep.  As such, insufficient sleep can disrupt this cycle, leading to weaker bones.

Growth Hormone stimulation

Deep sleep stimulates the release of a growth hormone, which is essential for bone growth and repair. Poor sleep can result in lower levels of this hormone, compromising our bone health.

Balance and co-ordination

Chronic sleep deprivation can impair balance and coordination, thereby increasing the risk of falls and fractures. Getting enough rest and sleep will help protect us from injuries that could compromise our bone integrity.

So how can you reduce your stress and improve your sleep?

To reduce stress

  • Exercise regularly – Physical activity is a great stress reliever and promotes bone health. Activities like yoga or tai chi can also improve balance and reduce the risk of falls. It will also give you more energy and make you feel ‘more alive’.
  • Mindfulness and Meditation – Practices like mindfulness and meditation can lower cortisol levels and reduce stress. By their nature, they are peaceful and bring calm.  Great for us in so many ways, not just for our bone health.
  • Healthy Diet – Eating a balanced diet rich in calcium, vitamin D and other bone-supporting nutrients can help mitigate the negative effects of stress on bone health.

To improve sleep

  • Establish a routine: Go to go to bed and wake up at the same time every day, even on weekends, to regulate your body’s internal clock.
  • Create a sleep-friendly environment – Keep your bedroom cool, dark and quiet. Consider using earplugs or an eye mask as these will help.
  • Limit screen time – Reduce exposure to screens an hour before bed as blue light can interfere with the production of melatonin, the sleep hormone. It’s best to have that pre-bed hour away from any electronic device.
  • Avoid stimulants – Limit your intake of caffeine and nicotine, especially in the hours leading up to bedtime.

Understanding the connection between stress, sleep and bone health is key to maintaining your overall wellbeing. By actively managing stress and prioritising good sleep, you can support your bones and reduce your chance of having osteopenia and osteoporosis and lessen your risk of fractures.