Background: Falls are leading cause of injury among older people, especially for those living in
long-term care facilities (LTCFs). Very few studies have assessed the effect of sleep quality and
hypnotics use on falls, especially in Chinese LTCFs. The study aimed to examine the association between sleep quality,
hypnotics use, and falls in institutionalized older people. Methods: We recruited 605 residents from 25 LTCFs in central Shanghai and conducted a baseline survey for sleep quality and
hypnotics use, as well as a one-year follow-up survey for falls and injurious falls. Logistic regression models were applied in univariate and multivariate analysis. Results: Among the 605 participants (70.41% women, mean age 84.33 ± 6.90 years), the one-year incidence of falls and injurious falls was 21.82% and 15.21%, respectively.
Insomnia (19.83%) and
hypnotics use (14.21%) were prevalent. After adjusting for potential confounders, we found that
insomnia was significantly associated with an increased risk of falls (adjusted risk ratio (RR): 1.787, 95% CI, 1.106-2.877) and the use of
benzodiazepines significantly increased the risk of injurious falls (RR: 3.128, 95% CI, 1.541-6.350). Conclusion: In elderly LTCF residents, both
insomnia and
benzodiazepine use are associated with an increased risk of falls and
injuries. Adopting non-pharmacological approaches to improve sleep quality, taking safer
hypnotics, or strengthening supervision on
benzodiazepine users may be useful in fall prevention.