Background Osteoporosis is a major health problem that can occur in people of all ages. It can stem from poor bone health during childhood and adolescence. It hinders independent living, impacts social living, reduces participation in physical activity, and increases risk of fractures and physical pain. In addition to age, gender, race, physical activity and diet, sleep is considered to be a risk factor in the development of osteoporosis in both the young and elderly population. Bone-specific alkaline phosphatase, a bone formation biomarker was measured to determine osteoporotic risk while an actigraphy device was used to measure sleep efficiency in college students. Objective The purpose of this study is to evaluate the relationship between sleep efficiency and bone-specific alkaline phosphatase levels. Recognition of any association may help in understanding how sleep is related to bone health. Methods Twenty-seven participants were recruited with the use of flyers distributed on campus and in residential halls, social media, email, and student newsletters. Bone-specific alkaline phosphatase biomarker was measured using human specific enzyme-linked immunosorbent assay (ELISA). Sleep data were collected from participants who wore ActiWatch for 7 days and completed a 7-night sleep diary. Linear and multiple regression analysis were performed to evaluate association between B-ALP (outcome) and sleep efficiency while adjusting for covariates (age, BMI, race, gender). Results and Conclusions Overall, there was no significant association between sleep efficiency and bone-specific alkaline phosphatase. Gender, however, showed a significant influence on the levels of bone-alkaline phosphatase. This is supported by a study that found higher bone turnover marker in males than in females. The result from the study could be due to limitations such as small sample size. More participants may provide a better comparison or association between variables. Genetic factors are believed to influence the outcome of the study as genetics can influence rate of bone loss or formation. Findings may be beneficial for public health and policy initiatives and allow health / nutrition educators to more adequately encourage proper habits such as physical activity, healthy diet and sufficient sleep for good bone health.