Elderly Women Increase Their Risk of Falling with
Less Than Five Hours Sleep
About one-third of adults older than age 65
experience falls each year
Sept.
8, 2008 - Women age 70 and older who sleep five hours or less per night
may be more likely to experience falls than those who sleep more than
seven to eight hours per night, according to a report in the September 8
issue of Archives of Internal Medicine, one of the JAMA/Archives
journals.
Additionally, the study finds that the use of sleep
medications does not appear to influence the association between sleep
and risk of falling.
Falls pose a major health risk among older adults
and are a leading cause of mortality [death], morbidity [illness] and
premature nursing home placement, according to background information
in the article.
About one-third of adults older than age 65
experience falls each year.
Insomnia and disturbed sleep as well as the use of
benzodiazepines (hypnotic medications to treat insomnia) are
increasingly common in older adults. It is not established whether it
is poor sleep or medications used to treat sleep disturbances that
explain the increased risk of falls in those who are prescribed such
medications.
Katie L. Stone, Ph.D., of the California Pacific
Medical Center Research Institute, San Francisco, and colleagues used
wrist actigraphies (watch-like devices) and sleep diaries to measure
sleep, sleep efficiency (the percentage of time in bed spent sleeping)
and frequency of falls in 2,978 women age 70 and older. Questionnaires
were used to determine demographic information and use of
benzodiazepines.
Participants averaged 6.8 hours of sleep per night
and spent an average 77.2 minutes awake after initial sleep onset. The
average number of falls one year after the collection of sleep data was
0.84. A total of 549 women (18.4 percent) had two or more falls during
the year after the sleep assessments, the authors write.
The risk of having two or more falls during the
following year was higher for women who slept five hours or less per
night compared with women who slept more than seven to eight hours per
night.
Compared with those with a sleep efficiency of 70
percent or higher, those with a sleep efficiency of less than 70 percent
were 1.36 times more likely to experience a fall. Similarly, women with
greater wake time after sleep onset (120 minutes or more) were 1.33
times more likely to fall than those who spent less than 120 minutes
awake after sleep onset.
In all, 214 subjects (7.2 percent) reported
current use of benzodiazepines, the authors write. Use of any
benzodiazepine (short and long combined) was associated with a 1.34-fold
increase in risk of falls, whereas short- and long-acting benzodiazepine
use was associated with an increased odds of 1.43 and 1.18,
respectively.
Future studies, in particular randomized trials,
are needed to determine the effects of newer pharmaceutical
interventions for insomnia (e.g., benzodiazepine receptor agonists) or
cognitive behavioral therapy for insomnia on risk of falls, the authors
conclude.
In addition, future studies using comprehensive
and objective measures of sleep should examine the interrelationships
between specific sleep characteristics (e.g., sleep-related breathing
disorder, hypoxia and measures of sleep duration and fragmentation) to
determine if these disorders contribute independently toward risk of
falls.
Editor's Note: This study was supported by Public
Health Service grants.
Sept.
8, 2008 - Women age 70 and older who sleep five hours or less per night
may be more likely to experience falls than those who sleep more than
seven to eight hours per night, according to a report in the September 8
issue of Archives of Internal Medicine, one of the JAMA/Archives
journals. 
