School of Public Health, University of Saskatchewan, Health Sciences Building E-Wing, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.
Robert Stempel College of Public and Social Work, Florida international University, Miami, FL, 33199, USA.
BMC Geriatr. 2018 Aug 28;18(1):196. doi: 10.1186/s12877-018-0889-x.
Falls pose major health problems to the middle-aged and older adults and may potentially lead to various levels of injuries. Sleep duration and disturbances have been shown to be associated with falls in literature; however, studies of the joint and distinct effects of those sleep problems are still sparse. To fill this gap, we aimed to determine the association between sleep duration, sleep disturbances and falls among middle-aged and older adults in China controlling for psychosocial, lifestyle, socio-demographical factors and comorbidity.
Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) based on multi-stage sampling designs, with respondents aged 50 and older. Associations were evaluated by using multiple logistic regression adjusting for confounders and complex survey design. To further determine if the association of sleep duration/disturbance and falls depends on age groups, the study data were divided into two samples (age 50-64 vs. age 65+) and comparison was made between the two age groups.
Of the 12,759 respondents, 2172 (17%) had falls within the last 2 years. Our findings indicated that the participants who had nighttime sleep duration ≤5 were more likely to report falls than those who had nighttime sleep duration ≥6 h; whereas no association between nighttime sleep duration > 8 h and falls. Participants having sleep disturbances 1-2 days, or 3-4 days, and 5-7 days per week were also more likely to report falls than those who had no sleep disturbance. The nap sleep duration was not significantly associated with falls. Although the combined sample found both sleep duration and sleep disturbance to be strongly associated with falls after adjusting for various confounders, sleep disturbance was not significantly related to falls among participants aged 65 + .
Our study suggested that there is an independent association between falls and short sleep duration and disturbed sleep among middle-aged and older adults in China. Findings underscore the need for evidence-based prevention and interventions targeting sleep duration and disturbance among this study population.
跌倒对中年和老年人造成严重的健康问题，并可能导致不同程度的伤害。睡眠时长和睡眠障碍与文献中的跌倒有关；然而，关于这些睡眠问题的联合和独特影响的研究仍然很少。为了填补这一空白，我们旨在确定中国中年和老年人的睡眠时长、睡眠障碍与跌倒之间的关联，同时控制社会心理、生活方式、社会人口学因素和合并症。
数据来自基于多阶段抽样设计的中国健康与退休纵向研究（CHARLS），受访者年龄在 50 岁及以上。使用调整混杂因素和复杂调查设计的多变量逻辑回归评估关联。为了进一步确定睡眠时长/障碍与跌倒的关联是否取决于年龄组，将研究数据分为两个样本（50-64 岁与 65 岁及以上），并比较两个年龄组之间的差异。
在 12759 名受访者中，2172 名（17%）在过去 2 年内发生过跌倒。我们的研究结果表明，夜间睡眠时长≤5 小时的参与者比夜间睡眠时长≥6 小时的参与者更有可能报告跌倒；而夜间睡眠时长>8 小时与跌倒之间没有关联。每周有 1-2 天、3-4 天和 5-7 天存在睡眠障碍的参与者也比没有睡眠障碍的参与者更有可能报告跌倒。午睡时长与跌倒无显著关联。尽管在调整了各种混杂因素后，合并样本发现睡眠时长和睡眠障碍都与跌倒有很强的关联，但在 65 岁及以上的参与者中，睡眠障碍与跌倒没有显著关系。
我们的研究表明，在中国中年和老年人中，跌倒与短睡眠时长和睡眠障碍之间存在独立的关联。这些发现强调了针对该研究人群的睡眠时长和睡眠障碍的基于证据的预防和干预措施的必要性。
