Disturbed sleep linked to falls in elderly

Nov 18 2013

By Joanna Lyford, Senior medwireNews Reporter

Sleep disturbances are associated with an increased risk for falls in certain older individuals, a population study suggests.

“These important new findings can contribute to the development of appropriate intervention strategies, particularly for these identified groups,” write Anna Katharina Helbig (German Research Center for Environmental Health, Neuherberg, Germany) and co-authors in Sleep Medicine.

The researchers obtained information on 1998 women and 1877 men aged between 65 and 93 years who were interviewed as part of the cross-sectional Cooperative Health Research in the Region of Augsburg (KORA)-Age study.

In all, 13.5% of the participants reported having had at least one fall in the previous 12 months. This subgroup was significantly more likely than “nonfallers” to report sleep disturbances, such as trouble falling asleep, trouble staying asleep, and sleepiness during the day.

Other characteristics that were associated with falls were use of psychotropic and antihypertensive medication, polypharmacy, older age, being female, living alone, being unmarried, being less physically active, use of tobacco and alcohol, and comorbidities such as eye disease, neurologic disease, depression/anxiety, and multimorbidity.

In a multivariate model that adjusted for all covariates, the association between sleep disturbances and falls was attenuated, reaching borderline statistical significance for trouble staying asleep (odds ratio [OR]=1.23) and becoming nonsignificant for the others.

A subgroup analysis suggested that the association between sleep difficulties and falls was more pronounced in people aged 76 years and over, with adjusted ORs of 1.76, 1.89, and 1.96 for trouble falling asleep, difficulty staying asleep, and daytime sleepiness, respectively.

Another analysis stratified by comorbidities found a significant association between longer sleep duration (>9 hours per night) and falls during the previous 12 months in people with no history of dizziness, with an adjusted OR of 1.47.

Commenting on their findings, Helbig et al note that, while it is widely believed that sleep duration decreases with advancing age, this may not be the case. In this study, the average sleep duration was 7.6 hours, which is within the normal range for younger adults.

They conclude: “[P]rospective studies are needed to clarify the association between sleep disturbances and falls in general and in particular to describe the interaction between sleep disturbances and age, dizziness, and polypharmacy regarding the association with falls among older community-dwelling men and women.”

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