Can a bad night’s sleep affect balance and increase fall risk?

A study in healthy adults investigated whether day-to-day variation in sleep quality affects standing balance and increases fall risk.

The ability to balance is essential for normal daily activities. Disturbed balance can lead to problems such as feeling dizzy or nauseous and having difficulty walking. It also increases the chances of falling. Maintaining balance involves several body systems working together, including the nervous system, inner ear, eyes, and skeletal muscles. Even while standing still, our bodies are constantlyadjusting to keep us balanced.

Previous studies have shown that extended sleep deprivation can impair balance, but it is not known whether day-to-day poor sleep quality could also have an effect. This could be important in assessing the fall risk in vulnerable individuals such asthe elderly. Researchers at the University of Warwick, United Kingdom,investigated whether daily changes in sleep quality could affect standing balance. They recently reported their findings in Scientific Reports.

The researchers recruited 20 healthy adult volunteers for the two-day study. After a baseline assessment of their general health, the volunteers were asked to wear a small unobtrusive device to monitor their sleep at home for two nights and also to complete a sleep diary questionnaire.

On the two mornings following sleep monitoring, the participants attended a laboratory session to wear standing balance. This was measured using a device to evaluate foot center of pressure. The researchers compared the balance in volunteers who had recorded good quality sleep with those who had poor quality sleep. They found that those with a poor sleep quality had a significant deteriorationin their standing balance.

The study results suggest that balance can be impaired even after just one night’s sleep disturbance. Dr. Leandro Pecchia, one of the research team leaders, commented, “We all have direct experience of this. When we do not sleep well, we may fella little dizzy…”  He added that when weare in good health, our body can adapt to keep our balance and avoid falls, butthis ability is reduced with aging or inpeople with medical conditions.

Prof. Francesoco Cappuccio, Head of the Sleep, Health and Society Programme at Warwick University agreed, “We would expect more dramatic effects when these experiments are replicated in older people, whose vulnerability to sleep disruption, postural hypotension and risk of falls is much greater”.

The team hopes that the study can contribute to the understanding of in-hospital falls. Poor sleep quality, due to the unfamiliar hospital environment or medications, increases the risk of falls. Finding a way to detect early changes in sleep quality could identify patients at increased fall risk. Taking steps to prevent falls by developing personalized care plans and interventions could help to prevent falls in elderly patients.

Written by Julie McShane, Medical Writer

References

1. Montesinos L, Castaldo R, Cappuccio F, et al. Day-to-day variations in sleepquality affect standing balance inhealthy adults. Scientific Reports (2018)8:17504. DOI:10)1038/s41598-018-36053-4.
2. Press release: Falls are more likely when you’ve had a bad night sleep.University of Warwick.https://www.eurekalert.org/pub_releases/2018-11/uow-fam113018.php