The relationships between sleep disturbance and falls: A systematic review

Abstract

The purpose of this systematic review was to examine critically the literature that addresses the association between sleep disturbance and falls. Electronic databases OVID MEDLINE, PubMed, and CINAHL were searched using MeSH terms “sleep” and “accidental falls.” Search limits included adults, humans, and English. The articles selected for the final sample were assessed for methodological quality. Eleven key attributes of sleep disturbance were extracted. The search yielded 177 articles from OVID MEDLINE, 124 from PubMed, and 46 from CINAHL. The final sample included 42 papers. The mean methodological quality score was 7.5 (range 2–10). Those who self‐report >11 h or ≤5 h of nocturnal sleep duration may have a greater fall risk, but variations in cutoff points, study designs, and data collection methods contribute to difficulty in comparing study results. Subjective sleep fragmentation is associated with falls. The few studies on obstructive sleep apnea and insomnia demonstrate evidence of an increased risk for falls. It remains unclear whether daytime sleepiness, self‐reported sleep quality, snoring, or napping are associated with falls, since some but not all studies demonstrate an association and the study quality did not differ.

Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

“…Periodic collapse of the upper airway during sleep in patients with obstructive sleep apnea causes chronic intermittent hypoxia and sleep interruption ( Gokmen et al, 2021 ). Obstructive sleep apnea and insomnia are associated with an increased risk of falls ( Gokmen et al, 2021 ; Knechel and Chang, 2022 ). It is not clear whether daytime sleepiness, self-rated sleep quality, snoring or napping are associated with falls, as some, but not all, and studies show an association between these variables ( Knechel and Chang, 2022 ).…”

“…Obstructive sleep apnea and insomnia are associated with an increased risk of falls ( Gokmen et al, 2021 ; Knechel and Chang, 2022 ). It is not clear whether daytime sleepiness, self-rated sleep quality, snoring or napping are associated with falls, as some, but not all, and studies show an association between these variables ( Knechel and Chang, 2022 ). When severe obstructive sleep apnea-impaired static postural balance is compared to mild to moderate (non-severe) obstructive sleep apnea, there was no difference between them in terms of dynamic postural balance and the risk of fall ( Gokmen et al, 2021 ).…”

“…Based on these previous considerations, it is logical that it has been suggested that the disturbance of postural balance caused by sleep deprivation may increase the risk of falling in humans ( Knechel and Chang, 2022 ). There would even be a relationship between sleep deprivation (or sleep disturbance/restriction) and falls in adults ( Knechel and Chang, 2022 ). Moreover, sleep deprivation increases the risk of road traffic accidents ( Herman et al, 2014 ; Cai et al, 2021 ).…”