St George Rebecca J, Delbaere Kim, Williams Philippa, Lord Stephen R
Prince of Wales Medical Research Institute, University of New South Wales, Randwick, N.S.W., Australia.
Gerontology. 2009;55(2):162-8. doi: 10.1159/000146786. Epub 2008 Jul 21.
Older people often experience unusual sleeping patterns and a poor quality of night-time sleep. Insufficient sleep has potential effects on cognition and physical functioning and therefore may increase the incidence of falls in older people.
To determine the extent to which a range of physiological, psychological and health-related factors predict night-time sleep quality of older people living in self-care and assisted-care, and whether poor sleep quality is a risk factor for falls.
572 people, 81 men and 491 women (mean age 79.7 years, SD 6.4), recruited from self-care retirement villages and assisted-care hostels participated in the cross-sectional study with a subgroup of 169 followed up for falls for 1 year. The main outcome measures were sleep quality and prospective falls.
Approximately half of the sample rated their sleep quality as poor or fair. Many measures of health, medication use and mood were significantly associated with ratings of poor night-time sleep quality. Multiple regression analyses revealed poor circulation, use of psychotropic and diuretic medications, negative affect, pain, not having a friend in the village, lower fitness levels and daytime napping were significant and independent predictors of night-time sleep quality in both residential care groups. Napping daily was reported by 28% of the self-care group and 37% of the assisted-care group. Residents across both care levels who napped >30 min during the day, or reported <6 h sleep at night, were three times more likely to suffer multiple falls in the follow-up year when adjusting for health, medication and activity measures.
Sleep disturbances were common and associated with a variety of psychological, physiological, health and lifestyle factors. Long daytime naps and short night-time sleep periods were associated with an increased risk of falls.
老年人经常经历不寻常的睡眠模式和夜间睡眠质量差的情况。睡眠不足对认知和身体功能有潜在影响，因此可能增加老年人跌倒的发生率。
确定一系列生理、心理和健康相关因素在多大程度上可预测生活在自理和辅助护理环境中的老年人的夜间睡眠质量，以及睡眠质量差是否是跌倒的危险因素。
从自理退休村和辅助护理宿舍招募了572人，其中81名男性和491名女性（平均年龄79.7岁，标准差6.4）参与了这项横断面研究，其中169人的亚组随访了1年的跌倒情况。主要结局指标是睡眠质量和预期跌倒情况。
大约一半的样本将他们的睡眠质量评为差或一般。许多健康指标、药物使用和情绪指标与夜间睡眠质量差的评分显著相关。多元回归分析显示，血液循环不良、使用精神药物和利尿剂、消极情绪、疼痛、在村里没有朋友、身体活动水平较低和白天午睡是两个居住护理组夜间睡眠质量的显著且独立的预测因素。自理组28%的人和辅助护理组37%的人报告每天午睡。在调整健康、药物和活动指标后，两个护理水平的居民白天午睡超过30分钟或夜间睡眠不足6小时，在随访年度发生多次跌倒的可能性是其他人的三倍。
睡眠障碍很常见，并且与多种心理、生理、健康和生活方式因素相关。白天长时间午睡和夜间睡眠时间短与跌倒风险增加有关。
