Dados do Trabalho

Título

Fragmented sleep, nocturia and sustained dessaturations are associated to the risk of falling in elderly: results from a systematic review

Introdução

Falls in people over 65 years old rank third among the causes of accidental deaths both in United States and Brazil. Inadequate or insufficient sleep are frequent causes of falls and accidental injuries, and sleep fragmentation was showed to increase the risk of both, particularly in elderly.

Objetivo

To evaluate the association between sleep fragmentation and risk of falling in the elderly.

Métodos

The PRISMA protocol was used as a guide for the systematic review. The descriptors were sleep fragmentation, accidental falls, and elderly. Inclusion criteria were cross-sectional studies; people aged 65 years or older, both sexes; studies that have evaluated sleep fragmentation and the occurrence of falls in the elderly. Exclusion criteria were studies involving animals; reviews; cards; abstracts; Congress proceedings.

Resultados

Out of 298 total studies, 09 articles were selected. The following results were observed: 1. Sleep fragmentation rates were associated with an increased risk of falls; 2. The average number of falls was 1.66 + 1.60, ranging from 1 to 14 falls. Falling while sleeping at night, walking during sleep, and waking up in the morning were variables related to the number of reported falls; 3. Men with 10% or more sleep time with arterial oxygen saturation < 90% were increased risk of having one to two falls compared to those who had < 1% of total sleep time with oxygen saturation < 90 %. For those men with worse oxygen saturation during sleep, the total sleep time was shorter, and the sleep fragmentation was higher. Furthermore, sleep fragmentation was directly related to the decrease in oxygen saturation levels, which, in turn, are associated with the increased occurrence of falls; 4. Nocturia three or more times a night was associated with a 1.27 increase in the risk of an incident fall in the elderly.

Conclusões

Results from this study show an association between sleep fragmentation and a greater risk of falling in elderly, especially in women. Of relevance, nocturia and drop in oxyhemoglobin saturation < 90% (in men) were identified as additional contributors which should be better explored in future research.

Palavras -chave

sleep fragmentation, accidental falls, elderly