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As many as 1 in 3 adults aged 65 and older fall each year. Because many older people have osteoporosis, or "thinning bones," these falls may cause bone fractures that can lead to disabilities, the need for nursing home care, or other adverse health outcomes.

Many older adults also have trouble sleeping. Often undiagnosed and untreated in older people, poor sleep can lead to daytime sleepiness, slowed reaction time and difficulty staying alert. These things can, in turn, boost risks of falls and bone fractures.

New Research in the Journal of the American Geriatrics Society

To get a better sense of how sleep and daytime napping - which often goes hand in hand with poor nighttime sleep -- affect risks of falls and fractures in older people, researchers studied 8,100 white women, aged 69 or older. All of the women had already volunteered for an osteoporosis study. Because osteoporosis-related bone fractures are less common among men and black women, only white women were included in the study.

To start, the researchers gave the women questionnaires asking them how many hours they slept each night, and whether, how long, and how often they napped during the day. Every four months after that, for more than six years, the researchers contacted the women and asked them if they had fallen or fractured a bone. If a woman reported a fracture, the researchers confirmed this with X rays or radiology reports.

The researchers found that women who said they got 10 or more hours of sleep during the course of a day appeared to run a higher risk of falling and fracturing a bone than women who slept just 8 to 9 hours a day. Why? It's possible that women who slept more each day had underlying health problems that made them more likely to fall. It's also possible that those who slept more hours each day had sleep disorders that resulted in poor quality sleep that left them tired and, as a result, at higher risk of falls and fractures.

In addition, the researchers found that women who said they took daytime naps were also more likely to fall and fracture a bone than those who didn't nap during the day. Why? It may be that those who napped did so because they got poor quality sleep at night and were sleepy and more likely to fall during the day. It's also possible that those who napped during the day woke up from their naps feeling groggy, and this made them more likely to fall. Other studies have found that younger people often wake up from naps feeling groggy. This may also happen to older people, the researchers point out.

Future research, they conclude, should investigate whether specific sleep disorders boost risks of falls in older adults.

What Should I Do?

If you're sleeping more than 9 hours a night, or are excessively tired and therefore taking naps during the day, you may not be getting a good night's sleep and may suffer from a sleep disorder. Talk to your health care provider about how you can improve the quality of the sleep you get. This may lower your risk of falls and bone fractures.

For more information about sleep in later adulthood, ways to get a better night's sleep, and tests and treatments for sleep disorders, visit Aging in the Know.

The summary above is from the full report titled, "Self-Reported Sleep and Nap Habits and Risk of Falls and Fractures in Older Women: The Study of Osteoporotic Fractures". It is in the August 2006 issue of the Journal of the American Geriatrics Society (Volume 54, Issue 8). The report is authored by Katie L. Stone, PhD; Susan K Ewing, MS; Li-Yung Lui, MS, MA; Kristine E Ensrud, MD, MPH; Sonia Ancoli-Israel, PhD; Douglas C. Bauer, MD; Jane A. Cauley, PhD; Teresa A. Hillier, MD; and Steven R. Cummings, MD.