nach oben

Zeitschrift für Gerontologie und Geriatrie

Erschienen in:

24.05.2023 | Themenschwerpunkt

Observed daytime sleepiness in in-hospital geriatric patients and risk of falls

verfasst von: Jeanina Schlitzer, Michaela Friedhoff, Barbara Nickel, Helmut Frohnhofen

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 7/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

Daytime sleepiness and falls are frequent in geriatric in-hospital patients; however, the relationship between both events is not clear. To test the hypothesis that observed daytime sleepiness is associated with falls in geriatric in-hospital patients data collected from medical records of patients who were admitted to an acute geriatric department were retrospectively analyzed.

Methods

The data from the medical records of patients who were admitted to the geriatric department of the Alfried-Krupp-Hospital in Essen, Germany in the period from January 2018 to March 2020 were retrospectively analyzed. Personal data, data concerning the geriatric assessment, observed daytime sleepiness, and falls were recorded.

Results

From a total of 1485 patients who were consecutively admitted to hospital, the data of 1317 (87%) patients could be included for further analysis. During the hospital stay 146 (11%) patients fell at least once, 35 (3%) patients had more than 1 fall and 64 falls (44%) occurred while patients were standing (bipedal fall). Daytime sleepiness was observed in 73% of the patients with bipedal falls and in 65% patients with nonbipedal falls (p < 0.01). Falls correlated significantly with the history of a recent fall, the length of hospital stay, the Barthel index (BI) on admission, the mini mental state examination (MMSE), dementia and observed daytime sleepiness. No correlation was found between falls and age, multimorbidity, and the number of drugs used. Drugs related to falls were medications to treat Parkinson’s disease, antidepressants and neuroleptics. In a multiple logistic regression analysis in-hospital falls were significantly and independently associated with a history of falls, length of in-hospital stay, dementia, and observed daytime sleepiness.

Conclusion

Observed daytime sleepiness is associated with in-hospital falls in geriatric patients. Prospective interventional studies are needed to confirm this relationship, and to quantify the impact of sleepiness on the risk of falling. Additionally, the impact of treatment for observed daytime sleepiness on the risk of falling should be assessed. The assessment of sleepiness should become a routine task in geriatrics.

Vorheriger Artikel Delirium and sleep disturbances—A narrative review

Nächster Artikel Frailty-Phänotyp und Risikofaktor gestörter Schlaf

Ambrose AF, Paul G, Hausdorff JM (2013) Risk factors for falls among older adults: a review of the literature. Maturitas 75:51–61. https://doi.org/10.1016/j.maturitas.2013.02.009CrossRefPubMed

Chantanachai T, Sturnieks DL, Lord SR et al (2021) Risk factors for falls in older people with cognitive impairment living in the community: Systematic review and meta-analysis. Ageing Res Rev 71:101452. https://doi.org/10.1016/j.arr.2021.101452CrossRefPubMed

Cohen ZL, Eigenberger PM, Sharkey KM et al (2022) Insomnia and other sleep disorders in older adults. Psychiatr Clin North Am 45:717–734. https://doi.org/10.1016/j.psc.2022.07.002CrossRefPubMed

Frohnhofen H, Fulda S, Frohnhofen K et al (2013) Validation of the Essener questionnaire of age and sleepiness in the elderly using pupillometry. Adv Exp Med Biol 755:125–132. https://doi.org/10.1007/978-94-007-4546-9_17CrossRefPubMed

Kuo H‑K, Yang CCH, Yu Y‑H et al (2010) Gender-specific association between self-reported sleep duration and falls in high-functioning older adults. J Gerontol Ser A Biol Sci Med Sci 65:190–196. https://doi.org/10.1093/gerona/glp143CrossRef

Latimer Hill E, Cumming RG, Lewis R et al (2007) Sleep disturbances and falls in older people. J Gerontol Ser A Biol Sci Med Sci 62:62–66. https://doi.org/10.1093/gerona/62.1.62CrossRef

Mayer G, Arzt M, Braumann B et al (2017) German S3 guideline nonrestorative sleep/sleep disorders, chapter “Sleep-related breathing disorders in adults,” short version: German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin, DGSM). Somnologie 21:290–301. https://doi.org/10.1007/s11818-017-0136-2CrossRefPubMedPubMedCentral

McNamara CS, Toner A, Murray L (2023) Preventing falls in older people on mental health inpatient wards: a quality improvement project. Nurs Older People 35:18–23. https://doi.org/10.7748/nop.2022.e1417CrossRefPubMed

Mesas AE, López-García E, Rodríguez-Artalejo F (2011) Self-reported sleep duration and falls in older adults. J Sleep Res 20:21–27. https://doi.org/10.1111/j.1365-2869.2010.00867.xCrossRefPubMed

10.

Montero-Odasso M, van der Velde N, Martin FC et al (2022) World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. https://doi.org/10.1093/ageing/afac205CrossRefPubMedPubMedCentral

11.

Oliveira SD, Pinto RZ, Gobbi C et al (2022) Sleep quality predicts functional disability in older adults with low back pain: a longitudinal study. J Appl Gerontol 41:2374–2381. https://doi.org/10.1177/07334648221113500CrossRefPubMed

12.

Onen F, Moreau T, Gooneratne NS et al (2013) Limits of the epworth sleepiness scale in older adults. Sleep Breath 17:343–350. https://doi.org/10.1007/s11325-012-0700-8CrossRefPubMed

13.

Peter-Derex L, Subtil F, Lemaitre G et al (2020) Observation and interview-based diurnal sleepiness inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia. J Clin Sleep Med 16:1507–1515. https://doi.org/10.5664/jcsm.8574CrossRefPubMedPubMedCentral

14.

Stone KL, Blackwell TL, Ancoli-Israel S et al (2014) Sleep disturbances and risk of falls in older community-dwelling men: the outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. J Am Geriatr Soc 62:299–305. https://doi.org/10.1111/jgs.12649CrossRefPubMedPubMedCentral

15.

Stone KL, Ewing SK, Lui L‑Y et al (2006) Self-reported sleep and nap habits and risk of falls and fractures in older women: the study of osteoporotic fractures. J Am Geriatr Soc 54:1177–1183. https://doi.org/10.1111/j.1532-5415.2006.00818.xCrossRefPubMed

16.

Teo JSH, Briffa NK, Devine A et al (2006) Do sleep problems or urinary incontinence predict falls in elderly women? Aust J Physiother 52:19–24. https://doi.org/10.1016/s0004-9514(06)70058-7CrossRefPubMed

17.

Zalai D, Bingeliene A, Shapiro C (2017) Sleepiness in the elderly. Sleep Med Clin 12:429–441. https://doi.org/10.1016/j.jsmc.2017.03.015CrossRefPubMed

Titel: Observed daytime sleepiness in in-hospital geriatric patients and risk of falls
verfasst von: Jeanina Schlitzer
Michaela Friedhoff
Barbara Nickel
Helmut Frohnhofen
Publikationsdatum: 24.05.2023
Verlag: Springer Medizin
Erschienen in: Zeitschrift für Gerontologie und Geriatrie / Ausgabe 7/2023
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI: https://doi.org/10.1007/s00391-023-02191-2

Springerpflege

Abstract

Background

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2023

Frailty-Phänotyp und Risikofaktor gestörter Schlaf

Delirium and sleep disturbances—A narrative review

Schlaf und Demenz

Delir bei Demenz

Mitteilungen der DGGG

Journal Club