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 Compared to people who slept through the night without any bathroom
trips, those who woke just once for the toilet on an average night
were 41 percent more likely to experience falls, the study found.
With three or more nightly bathroom trips, the risk of falls at
least doubled.
Plenty of previous research has documented an increased risk of
falling among elderly people with nocturia, or routine awakening to
use the bathroom during the night. But the current study looked at
men from 19 to 103 years old and suggests that even young people may
not be immune to the fall risk associated with this type of sleep
disruption, said senior study author Dr. Hyo Geun Choi, a researcher
at Hallym University College of Medicine in Anyang, South Korea.
"Nocturia could cause falls at night because several instances of
abruptly waking up to void may elevate the risk of incidental
falls," Choi said by email.
"In addition, nocturia is known to be a leading cause of sleep
fragmentation in elderly individuals," Choi added. "This disturbance
or fragmentation of sleep may induce daytime sleepiness, which
increases the risk of falls."
For the current study, Choi and colleagues examined data on the
history of falls in the previous year and incidents of nocturia for
than 92,000 men.
Overall, almost 15 percent of the men had a history of slipping or
falling, researchers report in PLoS ONE.
Among the men without any history of falls, 67 percent also had no
experience with nocturia.
But 40 percent of men with slips or falls in the past had at least
some experience with frequent nighttime awakenings to use the
bathroom.
When researchers looked just at the subset of younger men aged 19 to
30, they still found nocturia linked to falls. For these men, four
or five awakenings were associated with three times the odds of
falling.
With middle-aged men, 31 to 60, four or five instances of nocturia a
night were tied to slightly more than 50 percent higher odds of
falling.
It's possible that nocturnal waking might contribute to impaired
attention, psychiatric problems or chronic diseases that might make
falls more likely, Choi said.
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Often nocturia first occurs about two or three hours after sleep
begins, during a period of so-called slow wave sleep, Choi added.
Waking during slow-wave sleep can impact mood during the day and may
also contribute to poor blood sugar control in people with diabetes,
Choi said.
Waking to urinate once in the night is not considered abnormal,
according to the National Sleep Foundation, but two or more events
per night is linked to daytime sleepiness. People with severe
nocturia may wake five or six times during the night to go to the
bathroom and the frequent need to urinate is often a symptom of
another health condition, such as diabetes or prolapsed bladder.
Limitations of the study include a reliance on men to report how
often they fell or experienced nocturia, as well as a lack of
detailed data on when during sleep people awoke to use the bathroom.
Still, the findings offer more evidence linking nocturia to a risk
of falls, said Glenn Brassington, a researcher at Sonoma State
University in Rohnert Park, California, who wasn't involved in the
study.
"Awakening to go to the bathroom increases the opportunity for
falling," Brassington said by email.
"Frequent nighttime awakenings likely indicate that study
participants are not getting sufficient deep sleep, resulting in
impairments in memory, attention, coordination, and balance - all of
which are related to increased incidence of falling," Brassington
added.
SOURCE: http://bit.ly/2jjO7CB PLoS ONE, online January 6, 2017.
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