February 18, 2026

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, PhD, ScM, assistant professor in the Department of Orthopaedic Surgery, the study analyzed health data from nearly 500,000 participants enrolled in the UK Biobank. The findings, published in Arthritis Care & Research, suggest that sleep health may play an important role in joint health – beyond 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% to 40% higher risk of hip or knee osteoarthritis compared to those who slept about seven hours. Night shift workers had a pronounced increase in risk for knee osteoarthritis and total knee replacement, an association that remained even after accounting for body weight and other health factors. Notably, 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. Importantly, the associations were observed even among participants without chronic joint pain at baseline, indicating that poor sleep may contribute to osteoarthritis risk rather than simply 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.

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