Sleep-related injury in the elderly--an epidemiological study in Hong Kong.

OBJECTIVES

Sleep-related injury is a serious but under-recognized condition. We examined the occurrence of sleep-related injuries and REM sleep behavior disorder (RSBD) in a community sample of elderly in Hong Kong.

DESIGN

A representative sample of elderly aged 70 years or above were interviewed with a screening question on the presence of sleep-related injuries. Those who answered affirmatively as well as a subsample of negative responders were interviewed by clinicians. Patients with suspected sleep disorders underwent physical and psychiatric assessment as well as sleep studies.

SETTING

NA.

PATIENTS OR PARTICIPANTS

NA.

INTERVENTIONS

NA.

RESULTS

In total, 1034 elderly were surveyed and 0.8% reported history of sleep-related injury. Four subjects were confirmed to have RSBD, giving an estimated prevalence of RSBD of 0.38% (95% CI=0.01 to 0.76%). One subject had suspected RSBD but refused investigations while 1 had history suggestive of transient RSBD but could not be confirmed by the sleep studies. The course of RSBD in these subjects was that of a waxing and waning course instead of a progressive deterioration as described in previous literature. Two patients had been hospitalized for sleep-related injury before but their sleep disorder was not recognized.

CONCLUSIONS

We found that sleep-related injury and RSBD were not rare in the elderly but were frequently under-recognized. Our study calls for greater attention to elderly who had sustained injury during sleep.