Sleep Deprivation Is Associated with Bicycle Accidents and Slip and Fall Injuries in Korean Adolescents

The effect of sleep disorders, school jet lag, and anxiety in students 8-10 years of age on traumatic dental injuries

BACKGROUND/AIM

Traumatic dental injuries (TDI) constitute a public health problem. The aim of the present study was to investigate whether sleep disorders, school jet lag, and anxiety are associated with TDI in schoolchildren 8-10 years of age.

METHODS

An analytical, cross-sectional study was conducted with 739 pairs of parents/guardians and children enrolled in public and private schools. The parents/guardians answered a socioeconomic questionnaire, the Sleep Disturbance Scale for Children, Circadian Energy Scale, and Revised Children's Manifest Anxiety Scale. Four examiners underwent calibration exercises for the diagnosis of TDI (K > 0.80) using the criteria proposed by Andreasen (2007). A directed acyclic graph was used for the formulation of the theoretical model and statistical adjustments. Unadjusted and adjusted robust binary logistic regression analyses were performed (α = 5%).

RESULTS

The prevalence of TDI was 16.2%. The following variables remained associated with the outcome in the final model: family income less than or equal to the minimum monthly wage (OR = 1.77; 95% CI: 1.09-2.88; p = .02), child's height >137.6 cm (OR = 1.68; 95% CI: 1.06-2.64; p = .02), the occurrence of school jet lag (OR = 2.12; 95% CI: 1.27-3.53; p = .004), anxiety (OR = 1.77; 95% CI: 1.04-3.00; p = .04) and sleep disorders (OR = 1.63; 95% CI: 1.38-1.93; p = .05).

CONCLUSION

Children from families with a lower income, taller children, those with school jet lag, those with anxiety and those with sleep disorders had a greater occurrence of TDI.

Sleep characteristics and adolescent physical activity-related injuries in sports clubs, leisure time and schools

OBJECTIVE

Sleep has been identified as an important factor in relation to physical activity-related injury (PARI) in adolescents. The study aimed to explore associations between sleep duration, sleep problems and PARI among Slovak adolescents in three different settings: sports clubs, leisure time and schools.

METHODS

We analysed data from the cross-sectional Health Behaviour in School-aged Children study conducted in 2022 on a representative sample of 10 163 Slovak adolescents aged from 10.5 to 18.3 (mean age 13.4 (SD=1.5); 50.9% boys). Data were collected through self-administered online questionnaires completed by respondents in schools during the classes. Multiple logistic regression models were used to assess associations between sleep duration during schooldays and weekends, sleep problems and PARI in sports clubs, leisure time and schools.

RESULTS

Adolescents with normal sleep duration during schooldays and those who reported no problems with falling asleep, waking up at night and day sleepiness had a higher chance of not being injured during PA in sports clubs, leisure time and schools compared with adolescents with short sleep duration and sleep problems. Sufficient sleep duration during the weekend increased the probability of not having PARI in leisure time and schools, with the strongest association between long sleep duration and PARI in leisure time.

CONCLUSION

Good sleep quality and sufficient sleep duration were found to play a protective role in relation to PARI in adolescents. The findings suggest implementing sleep interventions in PARI prevention programmes, which must be considered a key component of adolescent PA promotion.

Association Between Sleep Quality and Falls: A Nationwide Population-Based Study from South Korea

Purpose

There are few large studies evaluating the association between sleep quality and the risk of falls. We aimed to determine the independent effect of poor sleep quality on an increased risk of falls using a large-sample dataset.

Methods

We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey on 201,700 participants. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2499 fallers who have experienced at least one fall during the past 12 months and 199,201 non-fallers. Multivariable logistic regression was performed to identify sleep quality variables significantly associated with an increased risk of falls.

Results

Fallers had poorer sleep quality (PSQI score >5) and higher scores for global PSQI and individual PSQI components than did non-fallers (all p < 0.001). Multivariable logistic regression adjusted for potential confounders including socioeconomic, physical health-related, and mental health-related variables showed that an increased risk of falls was associated with poor sleep quality (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.19–1.42). Subgroup analyses by age revealed that poor sleep quality was significantly associated with an increased risk of falls in all three adult age groups. Multivariable logistic regression using the seven PSQI components revealed that an increased risk of falls was associated with short sleep duration (OR 1.14, CI 1.09–1.20), increased sleep disturbances (OR 1.30, CI 1.16–1.46), and increased daytime dysfunctions (OR 1.21, CI 1.08–1.13).

Conclusion

Poor sleep quality caused by short sleep duration may be a principal risk factor of falls in adult populations. Increased sleep disturbances and daytime dysfunctions may also contribute to an increased risk of falls. Our results have clinical and public health perspectives that increasing sleep duration and reducing daytime dysfunctions and sleep disturbances could mitigate unintentional falls.

Factor structure and psychometric properties of the Persian versions of the Pediatric Daytime Sleepiness Scale and Morningness-Eveningness Scale for Children

BACKGROUND

The Pediatric Daytime Sleepiness Scale (PDSS) and the Morningness-Eveningness Scale for Children (MESC) are widely used to measure two important facets of sleep patterns, but neither have been adapted and validated for use in Iran. The purpose of this study was to examine the psychometric properties and factor structure of the Persian versions of the PDSS and the MESC in a sample of Iranian adolescents.

MATERIALS AND METHODS

The Persian versions of PDSS and MESC were translated and administered to a representative sample (n = 407) of Iranian early adolescents, aged 9-15 years, who attended school in morning shifts. The factor structure of both scales, found in prior studies, was tested using Confirmatory Factor Analyses to assess their validity and reliability.

RESULTS

The results revealed that the model fit indices of the one factor solution of the PDSS and the two factor solution of the MESC were acceptable to good. A high Pearson correlation was found between raw and latent factor scores for the PDSS and the two factors derived from the MESC (i.e., Morningness and Planning). Furthermore, the higher the PDSS score (more daytime sleepiness), the lower the MESC scores (more eveningness), indicating criterion validity of the scales showing the expected increase in daytime sleepiness in evening oriented adolescents who wake up early for attending school.

CONCLUSION

The Persian versions of the PDSS and the MESC can be considered reliable and valid tools for evaluating, respectively, daytime sleepiness and morningness-eveningness in the adolescent population of Iran.

Health-Risk Behavior-, Mental Health-, and Physical Exercise-Related Risk Factors for Tooth Fractures in Korean Adolescents

We aimed to determine factors related to tooth fracture experience in Korean adolescents. This study used data from the 14th Korea Youth Risk Behavior Survey in 2018, a cross-sectional web-based survey of health-risk behaviors among a representative sample of Korean middle- and high-school students aged 12-17 years. A total of 60,040 participants were selected using a complex sampling design of the survey from 400 middle schools and 400 high schools. They answered a self-administered questionnaire survey in classrooms. Explanatory variables included those pertaining to health-risk behaviors, mental health, and physical exercise. Complex-sample multivariable logistic regression models were applied to identify factors related to tooth fracture experience in the past 12 months. The overall prevalence of dental fracture experience was 11.4%. Risk factors related to tooth fractures in Korean adolescents were unhealthy behaviors such as alcohol and tobacco consumption; mental health problems including stress, depression, and suicidal ideation; and intensive physical exercise. The major risk factor related to tooth fractures was depression. To prevent tooth fractures among adolescents, schools should strengthen mental health education, encourage mouthguard use during intensive physical exercise, and develop school environments to prevent orofacial injuries. Further studies on various risk factors related to tooth fractures are warranted.

School start time change and motor vehicle crashes in adolescent drivers

STUDY OBJECTIVES

The aim of this study was to examine the association between a 50-minute delay (7:20 am to 8:10 am) in high school start times in Fairfax County (FC) Virginia and changes in rates of adolescent motor vehicle crashes. Crash rates in FC were also compared to those in the rest of the state during the same time period.

METHODS

Virginia Department of Motor Vehicles crash data in drivers age 16 to 18 years old between September and June of each year in FC versus the rest of the state were compared in the combined 2-year periods preceding (2013-2014 and 2014-2015; T1) and following (2015-2016 and 2016-2017; T2) school start time change in the fall of 2015.

RESULTS

The crash rate per 1000 in 16- to 18-year-old licensed drivers in FC during T1 was significantly higher compared to T2, 31.63 versus 29.59 accidents per 1,000 (95% confidence interval, 1.0-1.14, odds ratio 1.07, P = .03). In contrast, adolescent crash rates in the rest of Virginia were not statistically significantly different at T1 versus T2. With regard to subtypes of crashes, there was a trend toward significance in distraction-related crashes per 1,000 in FC at T1 compared to T2 at 7.01 versus 6.13 (95% confidence interval, 0.99-1.31, odds ratio 1.14, P = .05), but were not significantly different in the remainder of the state.

CONCLUSIONS

The results of this study suggest that school start time delay is associated with decreased adolescent motor vehicle crash risk, with significant implications for public health and safety.

Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-analysis

BACKGROUND

Although sleep has been identified as an important modifiable risk factor for injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied. The objective of this study was to quantitatively and qualitatively review published literature to examine if a lack of sleep is associated with sports injuries in adolescents and to delineate the effects of chronic versus acute lack of sleep.

METHODS

PubMed (includes MEDLINE) and EMBASE databases were systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported statistics regarding the relationship between sleep and sports injury in adolescents aged 19 years or younger published between January 1, 1997 and December 21, 2017. From these included studies, the following information was extracted: bibliographic and demographic information, reported outcomes related to injury and sleep, and definitions of injury and decreased sleep. A random effects model was then created to quantify the odds of injury with decreased sleep in adolescents.

RESULTS

Of 907 identified articles, 7 met inclusion criteria. Five studies reported that adolescents who chronically slept poorly were at a significantly increased likelihood of experiencing a sports or musculoskeletal injury. Two studies reported on acute sleep behaviors. One reported a significant positive association between acutely poor sleep and injury, whereas the other study reported no significant association. In our random effects model, adolescents who chronically slept poorly were more likely to be injured than those who slept well (OR, 1.58; 95% CI, 1.05-2.37; P=0.03).

CONCLUSIONS

Chronic lack of sleep in adolescents is associated with greater risk of sports and musculoskeletal injuries. Current evidence cannot yet definitively determine the effect of acute lack of sleep on injury rates.

LEVEL OF EVIDENCE

Level IV-systematic review of level II studies and one level IV study.

Adolescents’ Mobile Phone Use While Crossing the Road

Phones and other portable technology can be a distraction for pedestrians, affecting their ability to cross a road safely. This study focused on adolescents and investigated whether using a phone distracts attention while crossing the road. A field observation outside a secondary school in the north of England was carried out over a four-week period in 2018 with permission from the school. Observations included recording what accessories the pedestrian was carrying (phone, headphones or another electronic device) and their associated action (whether they were holding the device, speaking into a phone, looking at it, holding it to their ear or interacting with it manually). We observed whether the pedestrian looked (or failed to look) left and right before crossing the road, whether they crossed when the pedestrian light was on green or red, and whether they crossed within the cross-walk. We found that 31.37% of road crossings were made by adolescents with a phone or other device. They looked left and right before crossing less frequently when they had an electronic device with them, when looking at the screen and when texting or swiping. In conclusion, the safety of adolescent pedestrians is affected by mobile phones and music players.

Lack of sleep is associated with internet use for leisure

OBJECTIVE

Previous studies have suggested that excessive internet use may cause lack of sleep. However, recent studies have hypothesized that lack of sleep may instigate internet use for leisure. To elucidate the potential effects of sleep time on internet use, we explored the different associations between sleep time and internet use according to its purpose.

METHODS

The population-based, cross-sectional study group from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) collected data from 57,425 middle school students in 2014 and 2015. Sleep time over the past 7 days was classified into the following groups: < 7 h (6 h); ≥ 7 h, < 8 h (7 h); ≥ 8 h, < 9 h (8 h); and ≥ 9 h (9+ h). Internet use time per day was separately surveyed for leisure and for study and categorized as follows: 0 h; > 0 h, ≤ 1 h (1 h); > 1 h, ≤ 2 h (2 h); and > 2 h (2+ h) per day. Information on age, sex, region of residence, body mass index (BMI), economic level, parental education level, stress level, school performance level, and sleep satisfaction were retrieved. The relationships between sleep time and internet use time for leisure/study were analyzed using multinomial logistic regression with complex sampling. In the subgroup analysis according to sleep satisfaction (good, normal, and poor), the associations of sleep time with internet use for leisure were analyzed using the same methods.

RESULTS

Compared to 9+ h of sleep, less sleep was related to a long internet use time (2+ h) for leisure (adjusted odds ratio, AOR [95% confidence interval, CI] of sleep: 8 h = 1.23 [1.14-1.32]; 7 h = 1.42 [1.31-1.54]; and 6 h = 1.56 [1.44-1.70]; P < 0.001). Conversely, a relationship between less sleep and a long internet use time (2+ h) for study was evident only for 6 h of sleep (AOR of sleep: 8 h = 0.84 [0.84-1.04]; 7 h = 1.05 [0.94-1.17]; and 6 h = 1.32 [1.27-1.59]; P < 0.001). In the subgroup analysis according to sleep satisfaction, less sleep was associated with a long internet use time for leisure in all sleep satisfaction groups, although the relationship was more significant in the lower sleep satisfaction group.

CONCLUSION

Less sleep was significantly related to long-term use of the internet for leisure, whereas this association was not definite for internet use for study. Furthermore, poor sleep quality potentiated the relationship between less sleep time and internet use for leisure.

Atopic dermatitis is associated with active and passive cigarette smoking in adolescents

Objective

The relationship between passive smoking and atopic dermatitis has previously been reported, but few studies have simultaneously evaluated the association of atopic dermatitis with active and passive smoking.

Methods

The relationships between atopic dermatitis and active and passive smoking were evaluated in Korean adolescents. We used a large, representative, population-based survey (The Korea Youth Risk Behavior Web-based Survey) conducted in 2011 and 2012. Active smoking was classified into 3 groups (0 days, 1–19 days, and ≥ 20 days/month). Passive smoking was categorized into 3 groups (0 days, 1–4 days, and ≥ 5 days/week). Atopic dermatitis diagnosed by a medical doctor either during the past 1 month or during the participant’s lifetime was surveyed. Age, sex, obesity status, region of residence, economic level, and parental educational level of the participants were adjusted as confounders. Adjusted odds ratios (AORs) and 95% confidence intervals (CI) were calculated using multiple logistic regression analysis with complex sampling.

Results

A total of 6.8% (10,020/135,682) of the participants reported atopic dermatitis during the last 12 months. Active smoking was significantly associated with atopic dermatitis (previous 12 months) (AOR [95% CI] of smoking ≥ 20 days/month = 1.18 [1.07–1.29]; 1–19 days/month = 1.11 [0.99–1.23], P = 0.002). Passive smoking was also related to atopic dermatitis (previous 12 months) (AOR [95% CI] of smoking ≥ 5 days/week = 1.12 [1.05–1.20]; 1–4 days/week = 1.08 [1.03–1.13], P < 0.001).

Conclusion

Atopic dermatitis was significantly associated with active and passive smoking in Korean adolescents.

Sleep problems and injury risk among juveniles: A systematic review and meta-analysis of observational studies

Recent studies have reported inconsistent results regarding the association between sleep problems and injury risk among juveniles. Moreover, the extent of this risk remains largely unexplored. Thus, a systematic review and meta-analysis was conducted by our team to determine whether sleep problems increase the incidence of injuries among juveniles. PubMed, PsycINFO, Embase, and Cochrane Library databases were searched for relevant studies that explored the association between sleep problems and injury risk and have been published before July 2016. Multivariate adjusted odds ratio (OR) and associated 95% confidence intervals (CIs) were extracted and pooled using random-effects models. A total of 10 observational studies involving 73,418 participants were identified. Meta-analysis findings suggested that juveniles with sleep problems held a 1.64 times higher risk of injury than that of juveniles without sleep problems (OR: 1.64, 95% CI: 1.44–1.85). This relationship was also supported by subgroup analyses, which were based on different countries and study designs. The current evidence indicates that sleep problems are significantly associated with injury risk among juveniles. Sleep problems are highly important for young people; hence, sleep researchers and occupational physicians should focus on this aspect. Nevertheless, high-quality and adequately powered observational studies are still needed.

Nocturia Is Associated with Slipping and Falling

Several reports have demonstrated associations between falls and nocturia in the elderly. However, little information is available regarding other age groups. This study evaluated the relationship between the frequency of nocturia and falls in men using a large, population-based survey in Korea, and the results were adjusted for various confounding factors. Data from a 2011 Korean community health survey (KCHS) were retrieved for 92,660 men aged 19 to 103 years. Information regarding the history of slips or falls in the past year was collected. The frequency of nocturia was classified as 0, 1, 2, 3, 4, and ≥ 5 instances a night. Walking during the day, education, income, body mass index (BMI), smoking, alcohol consumption, sleep time, stress level and medical histories of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, angina or myocardial infarction, arthritis, and osteoporosis were adjusted using multiple logistic regression analysis with complex sampling. A subgroup analysis was conducted for young (19–30 years), middle-aged (31–60 years), and elderly individuals (61+ years). Approximately 14.6% of the men had a history of falls. Their mean age was 42.9 years, which was significantly higher than that of the non-faller group (P < 0.001). An increased frequency of nocturia was associated with increased adjusted odds ratio (AOR) for falls (AOR for 1 instance of nocturia/night = 1.41 [95% confidence interval, 1.33–1.50]; AOR for 2 instances = 1.41 [1.33–1.50]; AOR for 3 instances = 2.00 [1.75–2.28]; AOR for 4 instances = 2.12 [1.73–2.61]; AOR for ≥ 5 instances = 2.02 [1.74–2.36], P < 0.001). In the subgroup analysis, the AORs for falls significantly increased in all age groups as the frequency of nocturia increased.

Self-Regulation and Sleep Duration, Sleepiness, and Chronotype in Adolescents

OBJECTIVE

To determine whether shorter school-night sleep duration, greater daytime sleepiness, and greater eveningness chronotype were associated with lower self-regulation among adolescents.

METHODS

An online survey of 7th- to 12th-grade students in 19 schools in Fairfax County, Virginia Public Schools was conducted in 2015. Self-regulation was measured with the Behavior Rating Inventory of Executive Function, 2nd edition, Screening Self-Report Form. Sleep measures included school night-sleep duration (hours between usual bedtime and wake time), daytime sleepiness (Sleepiness Scale in the Sleep Habits Survey, tertiles), and chronotype (Morningness-Eveningness Scale for Children, continuous score and tertiles). Sociodemographic factors and mental health conditions were analyzed as potential confounders.

RESULTS

Among 2017 students surveyed, the mean age was 15.0 years (range, 12.1-18.9 years), and 21.7% slept <7 hours on school nights. In regression models adjusted for confounders, there was a significant independent association between self-regulation and both chronotype (P < .001) and daytime sleepiness (P < .001) but not sleep duration (P = .80). Compared with those in the lowest tertile of daytime sleepiness, those in the highest tertile had lower (0.59 SD units; 95% confidence interval, 0.48-0.71) self-regulation, as did those in the eveningness tertile of chronotype compared with those in the morningness tertile (0.35 SD units lower; 95% confidence interval, 0.24-0.46).

CONCLUSIONS

Among adolescents, greater daytime sleepiness and greater eveningness chronotype were independently associated with lower self-regulation, but shorter sleep duration was not. Aspects of sleep other than school-night sleep duration appear to be more strongly associated with self-regulation.

Association Between Obesity and Falls Among Korean Adults: A Population-Based Cross-Sectional Study

The objective of this study was to evaluate the association between falls and obesity using Asian body mass index (BMI) classifications. Using the data from the Korean community health survey in 2011, a total of 229,226 participants ranging from 19 to 106 years old were included in this study. The BMI groups were classified as underweight (<18.5), healthy (18.5 ≤ BMI < 23), overweight (23 ≤ BMI <25), and obese (≥25) using Asian BMI classifications. The associations between BMI groups and falls (≥1 time or ≥2 times per year) were analyzed using multiple logistic regression analyses with complex sampling. A subgroup analysis was conducted according to age (19-40, 41-60, and ≥61 years) and the location of the fall (indoor and outdoor). Physical activity, household income, education level, alcohol consumption, smoking, stress level, and medical comorbidities were adjusted as confounders. In total, 16.8% and 6.1% of the participants experienced falls ≥1 time and ≥2 times per year, respectively. Compared to the healthy weight group, the other BMI groups showed a significant U-shaped relationship with falls ≥1 time (AOR underweight = 1.12, 95% CI [confidence interval] = 1.05-1.19; AOR obese = 1.06, 95% CI = 1.02-1.10, P < 0.001) and ≥2 times (AOR underweight = 1.14, 95% CI = 1.04-1.26; AOR obese = 1.04, 95% CI = 0.99-1.10, P < 0.001). Obese status was significantly associated with falls (≥1 fall per year) in all age groups, whereas being underweight was significantly associated with falls in the 19 to 40 year age group only. In conclusion, both underweight and obese statuses were significantly associated with falls in this adult Korean population. However, the relationship between BMI group and falls varied according to age and the location of the falls.

Dietary Habits Are Associated With School Performance in Adolescents

Several studies suggest that dietary habits are associated with poor academic performance. However, few studies have evaluated these relations after adjusting for numerous confounding factors. This study evaluated the frequency of various diet items (fruit, soft drinks, fast foods, instant noodles, confections, vegetables, and milk) and the regularity of meal times (breakfast, lunch, and dinner) all at once.A total of 359,264 participants aged from 12 to 18 years old were pooled from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) for the 2009 to 2013 period. Dietary habits over the last 7 days were surveyed, including the regularity of consuming breakfast, lunch and dinner and the frequency of eating fruits, soft drinks, fast foods, instant noodles, confections, vegetables, and milk. Physical activity, obesity, region of residence, subjective assessment of health, stress level, economic level, and parental education level were collected from all of the study participants. School performance was classified into 5 levels. The adjusted odds ratios (AORs) of dietary habits for school performance were analyzed using multinomial logistic regression analyses with complex sampling. Structural equation modeling was used to analyze the effects of diet factors on school performance while considering the effects of other variables on both diet factors and school performance.Frequent intakes of breakfast (AOR = 2.34, 95% confidence interval [CI] = 2.20-2.48), fruits (AOR = 1.73, 95% CI = 1.62-1.86), vegetables (AOR = 1.48, 95% CI = 1.37-1.61), and milk (AOR = 1.35, 95% CI = 1.28-1.43) were related to high levels of school performance (each with P < 0.001). In contrast, soft drinks (AOR = 0.42, 95% CI = 0.38-0.46), instant noodles (AOR = 0.62, 95% CI = 0.55-0.70), fast food (AOR = 0.83, 95% CI = 0.72-0.96), and confectionary (AOR = 0.86, 95% CI = 0.80-0.93) were negatively associated with school performance (each with P < 0.001).This study confirms previous studies of school performance and dietary habits that find a positive association with eating breakfast and consuming fruits and milk and a negative relation with soft drinks, instant noodles, fast foods, and confections.

Excessive Sleep and Lack of Sleep Are Associated With Slips and Falls in the Adult Korean Population: A Population-Based Cross-Sectional Study

Few studies have evaluated the impacts of excessive sleep duration on falls. This study investigated the associations between sleep duration and falls among Korean adults in a wide range of age groups while adjusting for numerous confounding factors. Data collected from study participants ranging in age from 19 to 109 years old were analyzed from the 2013 Korean Community Health Survey (KCHS). Sleep duration was divided into 5 groups: ≤5, 6, 7, 8, and ≥9  hours per day. The relations between sleep duration and falls (≥1 time or ≥2 times per year) were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, days of vigorous or moderate physical activity, income, education, alcohol use, smoking, stress, obesity, hypertension, diabetes mellitus, hyperlipidemia, stroke, angina or myocardial infarction, arthritis, and asthma were controlled for as confounding factors. Associations between sleep duration and falls were analyzed in 19 to 40, 41 to 60, and 61+ year age groups. Furthermore, the relations between sleep duration and indoor versus outdoor falls were analyzed. Both ≤6 and ≥8  hours of sleep per day were significantly associated with an increased incidence of falls (≥1 time and ≥2 times per year) in the overall adult population (P < 0.001 in both instances). In a subgroup analysis, sleep durations of ≤5 and ≥9  hours were significantly associated with an increased incidence of falls (≥1 time a year) in each age group. Six hours of sleep was not significantly associated with falls (≥2 times per year) in the 61+ year age group, and 8 and 9  hours of sleep were not significantly associated with falls (≥2 times a year) in the 19 to 40 year age group. This study demonstrated that long as well as short sleep durations are associated with an increased incidence of falls. However, these relations were not evident in elderly populations with short sleep durations or in young adults with long sleep durations.