Sleep duration and sleep disturbances in association with falls among the middle-aged and older adults in China: a population-based nationwide study

Abstract

BackgroundFalls pose major health problems to the middle-aged and older adults and may potentially lead to various levels of injuries. Sleep duration and disturbances have been shown to be associated with falls in literature; however, studies of the joint and distinct effects of those sleep problems are still sparse. To fill this gap, we aimed to determine the association between sleep duration, sleep disturbances and falls among middle-aged and older adults in China controlling for psychosocial, lifestyle, socio-demographical factors and comorbidity.MethodsData were derived from the China Health and Retirement Longitudinal Study (CHARLS) based on multi-stage sampling designs, with respondents aged 50 and older. Associations were evaluated by using multiple logistic regression adjusting for confounders and complex survey design. To further determine if the association of sleep duration/disturbance and falls depends on age groups, the study data were divided into two samples (age 50–64 vs. age 65+) and comparison was made between the two age groups.ResultsOf the 12,759 respondents, 2172 (17%) had falls within the last 2 years. Our findings indicated that the participants who had nighttime sleep duration ≤5 were more likely to report falls than those who had nighttime sleep duration ≥6 h; whereas no association between nighttime sleep duration > 8 h and falls. Participants having sleep disturbances 1–2 days, or 3–4 days, and 5–7 days per week were also more likely to report falls than those who had no sleep disturbance. The nap sleep duration was not significantly associated with falls. Although the combined sample found both sleep duration and sleep disturbance to be strongly associated with falls after adjusting for various confounders, sleep disturbance was not significantly related to falls among participants aged 65 + .ConclusionsOur study suggested that there is an independent association between falls and short sleep duration and disturbed sleep among middle-aged and older adults in China. Findings underscore the need for evidence-based prevention and interventions targeting sleep duration and disturbance among this study population.

Falls, fear of falling and related factors in community‐dwelling individuals aged 80 and over in Turkey

“…Like other studies, this study found that sleep disturbance was related to falls . Recent studies have examined sleep disturbance among the fall‐related risks, but they did not consider it as a primary risk factor in the prevention of falls.…”

“…Like other studies, this study found that sleep disturbance was related to falls. 30 Recent studies have examined sleep disturbance among the fall-related risks, but they did not consider it as a primary risk factor in the prevention of falls. However, identifying and resolving sleep disturbance for those in advanced age may help to prevent falls and reduce fall risk.…”

Sleep Disturbances and Hip Fractures

“…Since both short as well as long sleep durations appear to be significantly associated with falls [33], it is recommended that older adults be carefully questioned by their care providers about their normal average nights length of sleep, and as required, help them to understand that both too little as well as too much sleep can prove equally problematic in increasing falls and fracture risk. The number of days in the week where poor sleep is evident should also be examined, as the falls risk increases with number of sleep related days reported [6]. Min et al [8] report that even if the association between sleep problems and risk of falls among the elderly are conflicting, some specific sleep problems such as extremely short sleep duration, daytime sleepiness and naps do appear to be significantly related to falls in a sufficient number of older adults, hence careful assessment of any sleep issue, followed by non pharmacologic tailored interventions appears warranted.…”

“…Those with mild cognitive impairments and dementia may experience more severe sleep problems and disease progression that often leads to falls and fractures [21] and should probably be carefully evaluated. According to Essien et al [6] the independent association between falls and short sleep duration and disturbed sleep among middleaged and older adults may warrant targeting in similar populations, and has truly not been done in a concerted way to date, with the exception of efforts to limit or withdraw medications that may foster falls risk.…”

“…This is noteworthy because among the many detrimental health issues associated with sleep deficits are numerous comorbid health conditions known to heighten fall risk [3], and possibly poor bone health [1], as well as falls and fall injuries that may result in one or bone fractures, especially fractures of the hip joint that impose so much excess morbidity and excess mortality rates among the elderly [4]. In turn, fractures such as those at the hip joint may lead to sleep disturbances, especially lengthy sleep durations [5] that are documented falls and hip fracture risk factors [6].…”