This study aimed to determine the association between falls and different symptoms of sleep disorders in community-dwelling older adults with disabilities.
Participants were community-dwelling older adults with disabilities in Hamamatsu City. The study period was September 2019 to September 2023. Exclusion criteria were difficulty walking, a mini-mental state examination score of ≤ 18, and communication difficulties.
This study was a prospective cohort study. The study period for the fall status was 12 months. Study participants recorded their falls on a daily calendar, and the examiner collected the calendar monthly. Seven symptoms of sleep disturbance were investigated at baseline: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. All are subitems of the Pittsburgh Sleep Quality Index.
For the statistical analysis, the Mann–Whitney U test was used to determine the association between the presence or absence of falls annually and each sleep disorder symptom. A logistic regression analysis was conducted using the presence of falls as the objective variable, symptoms of sleep disorders that were significantly different in the univariate analysis as explanatory variables, and the timed up-and-go test, sit-to-stand-five test (SS-5), one-leg standing time, presence of chronic pain, depression, and number of medications. The statistical analysis was performed using IBM SPSS Statistics Version 28, with a significance level of 5%.
The final analysis included 146 participants (99 women; mean age, 85.1±7.9 years; fall incidence, 38.4%). The fall group had significantly better sleep efficiency and use of sleeping medication than the non-fall group (p0.05). The logistic regression analysis revealed that sleep efficiency (odds ratio [OR]; 1.58, 95% confidence interval [CI]; 1.15–2.18), use of sleeping medication (OR; 1.57, 95% CI; 1.10–2.24), chronic pain (OR; 3.47, 95% CI; 1.57–7.65), and SS-5 (OR; 0.937, 95% CI; 0.88–0.99) were significantly associated with falls.
In addition to lower-limb muscle weakness and the use of sleeping medication, decreased sleep efficiency and symptoms of sleep disorders are associated with falls among community-dwelling older adults with disabilities.
A recent study employing physical therapy intervention for adults with disabilities and decreased sleep efficiency reported improvement in their sleep efficiency with the implementation of physical activity and cognitive behavioral therapy. The results suggest that combining measures to prevent falls in older adults with disabilities, including such conventional measures as exercise therapy and adjustments in sleeping medication, as well as measures to improve sleep efficiency, may help reduce the risk of falls.
Sleep disorder
Fall
