(P55) Association of Elderly Falls with Sleep Hours

Introduction/

Objective: Fall injuries are the most common cause of non-fatal injuries in the geriatric population in nursing homes in the United States. Poor sleep may increase the risk of falls in nursing homes, and more than 80% of nursing home residents are older than 65. We can learn about sleep habits in older adults from civilian data. This study aimed to investigate the effect of sleep duration as an independent risk factor for falls in the elderly using the National database and discuss the implications of these findings on the post-acute and long-term care population.

Design/Methodology: Older adults (≥ 65 years) who fell during a 3-month period between 2000 and 2014 were selected using the National Health Interview Survey (NHIS) database. They were categorized into two groups: Fall and No Fall. Characteristics of the Fall group were described using the appropriate statistical methods. Sleep was stratified as very short (≤ 4 hours), short sleep (5-6 hours), normal sleep (7-8 hours), and long sleep (≥ 9 hours). Finally, multivariable logistic regression analysis was performed to assess the relationship between falls and sleep duration after adjusting for confounding factors, including gender and race/ethnicity.

Results: Among 4,421 patients, 61.4% were in the Fall group during a 3-month period. Among the Fall group, 68.5% were female, 87.6% were Caucasian, 7.4% were African American, 2.9% were Asian, 8.1% were Hispanic, and 41.5% were married. Falls were higher in very short sleep (≤ 4 hours) and long sleep (≥ 9 hours) groups (67.5% and 74.8%, respectively). Long sleep was associated with higher odds of falls compared to normal sleep (OR 2.11 [1.63-2.73], p< 0.001).

Conclusion/

Discussion: Falls may increase morbidity and mortality in older adults in nursing homes. Very short sleep (≤ 4 hours) and long sleep (≥ 9 hours) were associated with falls in this study. Short sleep hours lead to daytime sleepiness and sedating medication use, increasing falls in nursing homes. Relation of falls to long sleep hours could be attributed to general physical inactivity and deconditioning or loss of muscle mass. Very short sleep may increase the risk of falls due to increased tiredness and weakness that typically accompanies reduced sleep. In nursing homes, patients’ sleep can easily be disrupted due to roommates, exposure to light and noise at night, or from nighttime care by staff. Providers should evaluate the sleep hours of patients in post-acute, long-term care, and assisted living facilities for each visit because providers can further investigate etiology and administer interventions to improve sleep quality and increase physical activity in residents with very short or long sleep hours. Screening of sleep hours with interventions could prevent falls in older patients of nursing homes. However, further research and data are required to explore this correlation and intervention effectiveness in nursing home settings.