Are sleep problems linked to a higher risk of falling in older adults?

Sleep problems are common in older adults and have been linked to a higher risk of falls. Research suggests that poor sleep may affect balance and walking quality, making falls more likely. Studies show that older adults with sleep issues have a 40-50% higher rate of falls and injurious falls compared to those without sleep problems.

What the research says

A 2025 study of 758 community-dwelling older adults (average age 75.8) found that those reporting sleep problems had a 42% higher rate of any fall and a 50% higher rate of injurious falls over one year ⁴. The same study showed that sleep problems were linked to lower gait quality (worse balance and walking pattern) but not to slower walking speed, suggesting that sleep affects the control of movement rather than just pace ⁴. Another study from the ARIC cohort (average age 75.5) found that older adults who used sleep medications had a 33% greater risk of falls over 6.5 years compared to non-users ⁷. This indicates that both sleep problems themselves and the medications used to treat them may increase fall risk. Additionally, a meta-analysis found that sleep disorders are associated with impaired glymphatic function (the brain's waste-clearing system), which may affect neurological health and balance ³. While this study did not directly measure falls, it suggests a biological pathway linking poor sleep to physical decline.

What to ask your doctor

• Could my sleep problems be affecting my balance or walking?
• Are there non-medication approaches to improve my sleep and reduce fall risk?
• If I take sleep medication, what are the risks for falls and are there safer alternatives?
• Should I have a gait or balance assessment if I have trouble sleeping?
• What lifestyle changes (like exercise or sleep hygiene) might help both my sleep and fall risk?