Introduction: We previously reported that lumbar spinal stenosis (LSS) is a risk factor for developing new sleep disorders, primarily insomnia. This study aims to examine the relationship between the coexistence of LSS and sleep disorders and the risk of falls.
Methods: We analyzed data from a community-based musculoskeletal health screening, the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS), conducted in 2008, focusing on participants aged 65 years and older. LSS, sleep disorders, and fall history were assessed through questionnaires. Participants were divided into four groups: a control group (no LSS, no sleep disorder), an LSS group, a sleep disorder group, and an LSS + sleep disorder group. Logistic regression analyses were performed to evaluate fall risk in each group, with age, sex, obesity, hypertension, diabetes, depression, smoking, and activity level as covariates. Statistical significance was set at p<0.05.
Results: A total of 893 participants (mean age 69.7 ± 4.5 years, 356 men and 537 women) were included in the analysis. Of these, 160 (19.1%) had a history of falls. Adjusted odds ratios (95% confidence intervals) for falls were 1.54 (1.02-2.33) in the LSS group, 0.76 (0.38-1.53) in the sleep disorder group, and 2.11 (1.05-4.26) in the LSS + sleep disorder group. The LSS group showed a significantly increased fall risk, which was further elevated in the LSS + sleep disorder group.
Discussion: LSS is a risk factor for falls, and this risk is further increased with the coexistence of sleep disorders. Insufficient treatment of LSS may lead to secondary insomnia due to lower limb pain and numbness, resulting in a heightened risk of falls. Timely and adequate intervention is essential to mitigate these risks.