Sleep problems as a risk factor for falls in a sample of community-dwelling adults aged 64-99 years

OBJECTIVES: The purpose of this study was to determine if reported nighttim e sleep problems and daytime sleepiness were associated with reported faili ng during the previous 12 months in a representatively sampled older adult population. DESIGN: Random-digit dial telephone survey. SETTING: Representatively sampled older adult population living in northern California. PARTICIPANTS: Participants were 971 women and 555 men, aged 64 to 99 years. MEASUREMENTS: Twenty-minute telephone interview adapted from the National H ealth Interview Survey. RESULTS: Two hundred and eighty-four participants reported falling during t he previous 12 months (19% of the sample). Significantly more women fell th an men (20 % and 14%, respectively, P < .001). The following variables were significant risk factors for falling in univariate analyses: female gender , being unmarried, living alone, income less than $15,000 per year, difficu lty walking, having more than one chronic medical condition, history of car diovascular disease, hypertension, arthritis, sensory impairment, psycholog ical difficulties, and nighttime sleep problems. All of the nighttime sleep problem variables remained significant risk factors for falling after cont rolling for other risk factors for falling. CONCLUSIONS: The results provide support for an independent association bet ween reported sleep problems and falls in an older population. One of the i mplications of these data is that behavioral research focusing on the effec tiveness of insomnia treatment in old age should: not only examine typical sleep-related outcomes (e.g., total time asleep, number of awakenings) but also the occurrence of falls as well.