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Sleep Disturbances and Risk of Falls in Older Community‐Dwelling Men: The Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study
Author(s) -
Stone Katie L.,
Blackwell Terri L.,
AncoliIsrael Sonia,
Cauley Jane A.,
Redline Susan,
Marshall Lynn M.,
Ensrud Kristine E.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12649
Subject(s) - medicine , pittsburgh sleep quality index , epworth sleepiness scale , polysomnography , odds ratio , confidence interval , physical therapy , sleep (system call) , excessive daytime sleepiness , obstructive sleep apnea , poison control , actigraphy , sleep disorder , apnea , insomnia , psychiatry , circadian rhythm , emergency medicine , sleep quality , operating system , computer science
Objectives To test the hypothesis that subjective and objective sleep disturbances are associated with risk of incident falls in older men. Design The prospective observational M r OS S leep S tudy. Setting Six academic clinical centers in the U nited S tates. Participants Community‐dwelling men aged 67 and older (mean 76) (n = 3,101). Measurements Subjective sleep measurements included daytime sleepiness ( E pworth S leepiness S cale ( ESS )), sleep quality ( P ittsburgh S leep Q uality I ndex ( PSQI )), and total sleep time ( TST ). Objective sleep measurements included actigraphic TST and sleep efficiency (an index of fragmentation) and sleep disordered breathing (measured using in‐home polysomnography). Fall frequency during the subsequent year was ascertained three times per year using questionnaires. Recurrent falling was defined as having two or more falls in the subsequent year. Results In multivariable‐adjusted models, participants with excessive daytime sleepiness ( ESS > 10) but not poor subjective sleep quality ( PSQI > 5) had greater odds of experiencing two or more falls in the subsequent year (odds ratio ( OR ) = 1.52 95% confidence interval ( CI ) = 1.14–2.03). Based on actigraphic recordings, the odds of having recurrent falls was higher for men who slept 5 hours or less ( OR = 1.79, 95% CI = 1.22–2.60) than for those who slept 7 to 8 hours. Actigraphically measured sleep efficiency was also associated with greater risk of falls, as was nocturnal hypoxemia (≥10% of sleep time with arterial oxygen saturation <90%; OR = 1.62, 95% CI = 1.17–2.24) but not apnea hypopnea index. Conclusion Subjective and objective sleep disturbances were associated with risk of falls in older men, independent of confounders.