Poor Sleep Tied to Increased Injury From Falls, Motor Vehicle Accidents

Megan Brooks

June 13, 2023

Confirming the importance of sleep health, new research shows that short and disrupted sleep increases the risk of fall-related and motor vehicle–related injury among US adults.

Among the study's key findings ― adults who get 4 hours or less nightly and those who have trouble staying asleep are significantly more likely to be injured than peers who sleep the recommended 7 to 8 hours and those who never have trouble staying asleep.

The findings were presented at SLEEP 2023: 37th Annual Meeting of the Associated Professional Sleep Societies.

"Stark Differences"

In 2020, 55.4 million (roughly 1 in 6) Americans sought medical attention for nonfatal, preventable injuries.

"Poor sleep has been identified as a risk factor for preventable injuries," study investigator Clarence Locklear, MA, who is a PhD student with the Center for Translational Sleep and Circadian Sciences, University of Miami Miller School of Medicine in Florida, told Medscape Medical News.

For the study, the researchers examined associations between different types of sleep problems and different types of injuries utilizing data on 31,568 adults who participated in the 2020 National Health Interview Survey.

They investigated three types of injuries (fall-related, sports-related, and motor vehicle–related) and four domains of past-month sleep health: (1) sleep quantity: very short (≤4 hours), short (5–6 hours), healthy (7–8 hours), or long (≥9 hours); (2) sleep quality: trouble falling asleep and trouble staying asleep; (3) feeling well rested upon waking up; and (4) sleep medications.

Overall, 9% of adults suffered an injury in the prior 3 months. Among injured adults, 47% had a fall-related injury, 29% had a sports-related injury, and 6% had a motor vehicle–related injury.

Adults with very short sleep, those with short sleep, and those with long sleep were 37%, 15%, and 22% more likely to be injured than adults with healthy sleep (P < .05), the researchers found.

Those who had trouble staying asleep were 36% more likely to be injured than peers who never had trouble staying asleep (P < .01).

Adults who never woke up feeling rested and those who woke up feeling rested only on some days were 49% and 36% more likely to be injured (P < .01), respectively, than peers who always felt rested on waking.

Individuals who on some days took medication for sleep were 24% (P < .05) more likely to suffer an injury and those who took sleep medication every day were 36% (P < .001) more likely to get injured than those who never took sleep medication.

"These are pretty stark differences," said Locklear.

Regarding injury type, those who had trouble staying asleep some days were 22% (P < .05) more likely to have a fall-related injury and were 3.5 times (P < .01) more likely to experience a motor vehicle–related injury than peers who didn't have trouble staying asleep.

People who took sleep medication most days were 2.4 times more likely to suffer a fall than those who never took sleep medication. In addition, adults who reported long sleep (9+ hours nightly) were 43% less likely to have sports-related injuries (P < .05) than healthy sleepers (7–8 hours).

Quantity and Quality Matter

Commenting on the study for Medscape Medical News, Michael Breus, PhD, clinical psychologist and founder of TheSleepDoctor.com, said the results are "not particularly surprising but are consistent with other data."

Breus said, "Many people don't realize it's not just sleep deprivation, in terms of minutes, that's a problem. Our quality of sleep also matters. You can get 8 hours of crappy sleep and still injure yourself playing sports or get into a car accident due to poor reaction time."

As previously reported by Medscape Medical News, the American Heart Association recently added healthy sleep as an essential component of heart health. "It's nice to see them recognize that sleep is a big deal, and we've got the data to back it up," said Breus.

He noted that people often ask him what's the one thing they can do to improve sleep.

"The answer is always, wake up at the same time every single day, including the weekend, because your circadian system realigns every single morning.

"I solve maybe 50% to 60% of people's problems by just telling them to just wake up at the same time 7 days a week. I personally have been doing it for a very long time," said Breus.

The study was supported by the National Heart Lung and Blood Institute. Locklear and Breus have no relevant disclosures.

SLEEP 2022: the 37th Annual Meeting of the Associated Professional Sleep Societies: Abstract 0817. Presented June 6, 2023.

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