SLEEP QUALITY AND DURATION AND RISK OF FALLS IN OLDER ADULT WOMEN: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)

Abstract Background As the leading cause of injury in American older adults, falls can be consequential for function and mortality, but are preventable. Sleep may be a modifiable risk factor for falls. We hypothesized poorer sleep quality and shorter sleep duration would be associated with increased risk of falls and a greater number of falls. Methods The Study of Women’s Health Across the Nation is a multi-ethnic, community-based longitudinal study of women followed through and beyond the menopausal transition. In 2010-2011, participants self-reported measures of sleep quality and duration. In 2015-2016, participants reported number of falls in the year prior. Adjusted models included demographic and socioeconomic factors, and health conditions. Results Women who reported frequent (5+ times/week) trouble falling asleep and frequent waking in the middle of the night in 2010-2011 had a 27% (RR=1.27, 95% CI=1.01,1.62) and 24% (RR=1.24, 95% CI=1.01,1.48) increased risk of a subsequent fall. Frequent trouble falling asleep and short sleep duration (< 6 hours) were both associated with higher likelihood of recurrent falls (>=3 falls vs. <=1 fall) (OR=2.54, 95% CI=1.30,4.96; OR=1.80, 95% CI=1.07,3.05). Conclusions: Multiple indicators of poor sleep including trouble falling asleep, frequent waking, and short duration were associated with increased fall burden in older adult women. As falls pose a major risk factor for decline in health and mortality, promoting adequate, high-quality sleep may be an essential component in fall prevention.