Association between nighttime sleep duration and falls among community-dwelling older adults aged 65 and over: findings from a nationwide population-based study

BACKGROUND: It's well established that falls are a leading cause of injury among older adults and may be influenced by sleep duration. This study aimed to investigate the association between nighttime sleep duration and fall risk in a nationally representative older population. METHODS: This population-based cross-sectional study used data from the Turkey Older adults Profile Survey conducted in 2023. A total of 10,321 community-dwelling adults aged 65 years and older were included. Data on demographics, health characteristics, sleep duration, environmental factors, and fall history were collected through structured interviews. Univariable and multivariable logistic regression models were undertaken to estimate the association between nighttime sleep duration (< 7 h, 7-8 h [reference], and > 8 h) and falls. Multivariable models progressively adjusted for age, gender, education, marital status, physical activity, BMI, alcohol use, regular medication, walking difficulty, visual impairment, depression, chronic disease status, self-rated health, and environmental factors. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated. RESULTS: Among the participants (mean age: 72.8 ± 6.4 years; 54.5% female), 20.1% reported falls in the past year. Short sleep duration (< 7 h) was associated with significantly increased odds of falling in both unadjusted (OR = 1.755, 95% CI: 1.584-1.944, p < 0.001) and fully adjusted models (aOR = 1.546, 95% CI: 1.388-1.724, p < 0.001). Long sleep duration (> 8 h) initially indicated an elevated fall risk (OR = 1.224, 95% CI: 1.036-1.447, p = 0.018); however, this association lost statistical significance after fully adjusting for several health and environmental covariates (aOR = 1.091, 95% CI: 0.918-1.297, p = 0.322). CONCLUSIONS: Nighttime sleep duration less than 7 h was independently associated with an increased risk of falls among older adults. Interventions promoting optimal sleep duration could be a crucial component of fall prevention strategies targeting older populations.