Sleepiness and the Risk of Falling
Condition: Aging; Balance; Sleep
Study type: Interventional

Summary: 
      The purpose of this project is to examine the impact of sleeping pills and waking up in the
      middle of the night on walking balance and cognitive function, to identify risk factors for
      falls in older adults. A significant percentage of falls, approximately 33 to 52 percent,
      occur during the nighttime and morning hours when people are normally sleeping; therefore, it
      is possible that sleep and sleeping medication related impairments in balance may contribute
      to this risk.
    

Detailed description: 
      Awakening from sleep is well documented to impair cognitive performance in young adults. This
      phenomenon, called sleep inertia, has been reported to impair performance just as much as one
      night of total sleep deprivation, suggesting that there are significant functional
      consequences to sleep inertia. However, whether walking stability is impaired by sleep
      inertia is unknown. If sleep inertia impairs walking stability, it could be an important but
      currently unrecognized risk factor for falls in older adults. Also, the impact of aging on
      sleep inertia-related impairments in cognitive performance is unknown.

      Sleeping medication use is higher in older than younger adults, and is a risk factor for
      falls. Current evidence suggests that sleeping medications impair walking stability and
      cognitive performance in young and older adults during wakefulness; however, no study has
      examined walking stability and cognitive performance of young and older adults upon awakening
      from sleep at night after taking a hypnotic (sleeping medication). Therefore, the purpose of
      this study is to determine whether sleep inertia and hypnotic use impairs walking stability
      and cognitive performance more in healthy older than in healthy younger adults. It is
      expected that findings from the proposed study will provide evidence for sleep inertia as a
      risk factor for falls in older adults.

      Twelve older (aged 60-85) and twelve younger (aged 18-35) healthy male and female volunteers
      will participate in the study. The investigational procedures will include medical screening
      (e.g., physical, blood and urine tests, and bone mineral density assessment), home monitoring
      of sleep schedules for three weeks, and three overnight visits in the laboratory spaced
      approximately one week apart. During the laboratory visits, participants will be awakened in
      the middle of the night to perform walking stability and cognitive function tests. Before
      going to bed, participants will take either a placebo pill or a sleeping medication. On one
      of the visits, participants will be asked to go to bed about 2 hours later than usual.
    

Intervention name(s): zolpidem
Intervention type(s): Drug
Intervention MeSH terms: Zolpidem
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double
Primary purpose: Treatment
Keywords: Performance; Gait stability; sedative; hypnotic; quality of life; sleep disorder; wakefulness; sleeping pills; Cognitive function