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Sleep, insomnia and falls in elderly patients
Katie L Stone1, Kristine E Ensrud, Sonia Ancoli-Israel
1California Pacific Medical Center, Research Institute, San Francisco, CA 94107, USA. kstone@sfcc-cpmc.net
Sleep Medicine
|December 17, 2008
Summary
Sleep problems in older women increase fall risk, independent of insomnia medication use. Benzodiazepine use also elevates fall risk, though the link is less clear when sleep issues are considered.
Area of Science:
- Gerontology
- Sleep Medicine
- Epidemiology
Background:
- Insomnia is prevalent in older adults, leading to daytime dysfunction.
- Sleep disturbances and related medications may increase fall and fracture risks in the elderly.
- The independent impact of poor sleep versus hypnotic drug use on falls remains unclear.
Purpose of the Study:
- To investigate the independent effects of sleep problems and benzodiazepine use on fall risk in elderly women.
- To analyze data from the Study of Osteoporotic Fractures (SOF) cohort.
Main Methods:
- Analysis of data from the Study of Osteoporotic Fractures (SOF) cohort.
- Subjective and objective measurements of sleep problems.
- Consideration of benzodiazepine use as a confounding factor.
Main Results:
- Sleep problems, both subjective and objective, are linked to increased fall risk in community-dwelling older women.
- Benzodiazepine use is associated with a higher risk of falls.
- The association between benzodiazepine use and falls is less pronounced when sleep problems are accounted for.
Conclusions:
- Fall risk should be a key consideration when prescribing benzodiazepines to older adults.
- Further research is needed on the efficacy and safety of non-benzodiazepine treatments for insomnia in the elderly concerning fall prevention.
- Future insomnia treatment trials should incorporate fall risk factors like postural sway and reaction time.
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