Sleep disturbance may heighten fall, fracture risks

Individuals with sleep disturbance are at increased risk of experiencing a fall event and developing fracture, as suggested in a study.

Researchers explored the associations of sleep disturbance with bone mineral density (BMD) and risk of falls and fractures over 10.7 years. The analysis included a cohort of 1,099 participants (mean age 62.9 years) enrolled at baseline, among whom 875, 768, and 563 participants completed follow-up at 2.6, 5.1, and 10.7 years, respectively.

Assessments were performed at each visit. These included self-reported sleep disturbance, BMD (dual-energy x-ray absorptiometry), falls risk score, and fracture. The short-form Physiological Profile Assessment was used to calculate falls risk score expressed as Z-score. Fractures were self-reported.

Multivariable mixed-effects models and generalized estimating equations facilitated analysis of data. Results revealed a dose-response association between the extent of sleep disturbance and falls risk score, and this was prominent among individuals reporting the worst sleep disturbance (β, 0.15/unit, 95 percent confidence interval [CI], 0.02–0.28).

Compared with individuals who had no sleep problems, those with worst sleep disturbance also had a greater risk of any fracture (relative risk [RR], 1.30/unit, 95 percent CI, 1.01–1.67) and vertebral fracture (RR, 2.41/unit, 95 percent CI, 1.00–5.80). The risk for vertebral fracture was especially evident in women but not in men (RRs, 2.07 to 6.02; p<0.05).

The associations were independent of covariates, hip BMD, and falls risk. Meanwhile, there was no significant relationship between sleep disturbance and BMD at the hip, spine, or total body.

Additional studies needed to confirm and identify underlying mechanisms.