Falls

Why are falls a concern?

Falls can occur at any age, from children tumbling off furniture to older adults losing balance. For seniors, falls can be especially serious, leading to broken bones, loss of independence, or complications from conditions like osteoporosis.

Common causes of falls include:

• Balance problems
• Certain medicines that cause dizziness or confusion
• Vision difficulties
• Alcohol use affects balance and reflexes
• Muscle weakness in the legs
• Illnesses such as low blood pressure, diabetes, or neuropathy
• Slow reflexes that make it hard to react quickly
• Slipping or tripping due to poor footing or traction

How can falls be prevented?

• Have regular eye exams to maintain good vision
• Exercise regularly to strengthen muscles, improve balance, and support bone health
• Remove tripping hazards and install rails on stairs and in bathrooms
• Ensure adequate calcium and vitamin D intake to keep bones strong

Tip: Even small changes, like better lighting or safer home setups, can significantly reduce fall risks for people of all ages.

NIH: National Institute on Aging (NIA)

What is sleep?

Sleep is a biological process where the body and brain remain active while you are unconscious. It supports overall health, memory, and daily functioning. Poor or insufficient sleep can affect both physical and mental well-being.

What are sleep disorders?

Sleep disorders are conditions that disrupt normal sleep patterns. There are more than 80 types, including:

• Insomnia: Difficulty falling or staying asleep
• Sleep apnea: Breathing pauses during sleep lasting 10 seconds or more
• Restless leg syndrome (RLS): Tingling or uncomfortable sensations in the legs with a strong urge to move them
• Hypersomnia: Excessive daytime sleepiness, including narcolepsy
• Circadian rhythm disorders: Disrupted sleep-wake cycles, making it hard to sleep or wake at the right times
• Parasomnia: Unusual behaviors during sleep, such as walking, talking, or eating

What causes sleep disorders?

• Medical conditions such as heart or lung disease, nerve disorders, or pain
• Mental health conditions like depression or anxiety
• Medications
• Genetics
• Lifestyle factors such as caffeine, alcohol, or irregular work schedules
• Aging, which reduces deep, restful sleep

What are the symptoms?

Signs you may have a sleep disorder include:

• Taking longer than 30 minutes to fall asleep
• Waking up frequently at night or too early in the morning
• Feeling excessively sleepy during the day or needing frequent naps
• Snoring, gasping, or pauses in breathing during sleep
• Creeping or tingling sensations in the legs or arms, often relieved by movement
• Jerking movements of legs or arms during sleep
• Vivid dreamlike experiences or sudden muscle weakness when emotional
• Feeling unable to move when first waking up

How are sleep disorders diagnosed?

Providers may use your medical and sleep history, a physical exam, or a sleep study (polysomnogram). Common tests track:

• Brain wave activity
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate and electrical signals in muscles

Other tests may measure how quickly you fall asleep during the day or your ability to stay awake.

What are the treatments?

Treatment depends on the type of disorder and may include:

• Practicing good sleep habits and lifestyle changes
• Cognitive behavioral therapy or relaxation methods
• CPAP machines for sleep apnea
• Bright light therapy for circadian rhythm disorders
• Short-term use of sleeping pills or melatonin (with provider guidance)

What is a fracture?

A fracture is a break in a bone, usually caused by injury. Because fractures can be serious, it is important to seek medical attention right away if you think you may have one.

What are the types of fractures?

Fractures can be described in different ways depending on:

• Whether the bone is partially or completely broken
• Whether the break pierces the skin (open/compound) or remains internal (closed)
• The shape or direction of the break, such as a line across the bone
• The cause, such as stress fractures from overuse
• Which bone is affected, for example, facial fractures involving the nose or jaw

What causes fractures?

• Car accidents, falls, or sports injuries
• Repetitive motion or overuse
• Bone conditions such as osteoporosis or low bone density, which increase risk

What are the symptoms?

Symptoms vary depending on the bone but may include:

• Intense pain
• Visible deformity or limb appearing out of place
• Swelling, bruising, or tenderness
• Difficulty moving the injured part

How are fractures diagnosed?

A health care provider will perform a physical exam and may order an x-ray or other imaging test to confirm whether a bone is broken.

How are fractures treated?

• The most common treatment is wearing a cast or splint to keep the bone stable while it heals. Duration depends on the type of fracture and bone affected.
• In some cases, surgery may be needed to insert plates, pins, or screws to secure the bone.

Can fractures be prevented?

Prevention focuses on bone strength and fall reduction:

• Strengthen bones by:
  • Getting enough calcium and vitamin D
  • Staying physically active with weight-bearing exercises
  • Seeking treatment for osteoporosis or low bone density if needed
• Prevent falls by:
  • Removing tripping hazards in the home
  • Use caution on wet or icy surfaces
  • Wearing proper footwear

What is insomnia?

Insomnia is a common sleep disorder that makes it difficult to fall asleep, stay asleep, or get restful sleep. It can lead to feeling unrefreshed in the morning, daytime fatigue, and poor concentration.

Types of insomnia

• Acute (short-term): Often caused by stress, family pressures, or a traumatic event. Lasts days or weeks.
• Chronic (long-term): Lasts more than a month. May be linked to medical conditions, medications, or other sleep disorders. Substances such as caffeine, alcohol, and tobacco can also contribute.
• Primary insomnia: Not caused by another condition; often associated with stress, travel, or shift work.

Who is at risk?

You may be at higher risk of insomnia if you:

• Experience stress or emotional distress
• Are depressed or dealing with loss, such as the death of a spouse
• Work night shifts or irregular hours
• Travel long distances with time changes
• Lead an inactive lifestyle
• Have a lower income or limited resources
• Are older in age
• Belong to certain groups; research shows African Americans are more likely to experience insomnia and related sleep difficulties

Symptoms of insomnia

• Difficulty falling asleep or staying asleep
• Short sleep periods or frequent waking
• Feeling unrested despite spending hours in bed
• Waking too early
• Feeling as if no sleep occurred at all

Complications of insomnia

Insomnia can lead to daytime sleepiness, anxiety, irritability, and reduced focus. It increases risk of accidents, including car crashes, due to drowsy driving. It may also worsen depression or other health conditions

How is insomnia diagnosed?

A health care provider may:

• Review your medical and sleep history
• Ask detailed questions about sleep habits
• Perform a physical exam to check for other conditions
• Recommend a sleep study to measure sleep quality and body responses during rest

Treatments for insomnia

• Lifestyle changes: Good sleep habits, such as consistent bedtimes, limiting caffeine, and creating a restful sleep environment
• Cognitive behavioral therapy (CBT): Helps reduce anxiety and behaviors that interfere with sleep
• Medications: Short-term use of sleep aids may be prescribed, but typically alongside lifestyle adjustments
• Addressing underlying conditions: If insomnia is a symptom of another health problem, treating that condition is important

NIH: National Heart, Lung, and Blood Institute (NHLBI)

What are balance problems?

Balance problems occur when you feel dizzy, lightheaded, or as if the room is spinning. They can make you unsteady and may also cause blurred vision, confusion, or disorientation. These issues can increase the risk of falls and related injuries, such as hip fractures.

What causes balance problems?

• Inner ear disorders
• Brain or heart conditions
• Aging or head injuries
• Infections or circulation issues
• Side effects of certain medications

Why should balance problems be checked?

Balance difficulties can signal other health concerns, including ear infections, stroke, or neurological conditions. A doctor may recommend tests such as:

• Hearing exams
• Blood tests
• Imaging studies of the head and brain
• Tests that measure eye movements and body responses to motion

How are balance problems managed?

• Treating the underlying cause, such as an infection or circulation issue
• Prescribed exercises to improve stability
• Dietary adjustments
• Medications that help with dizziness or disorientation

Tip: Because balance issues may point to serious conditions, it is important to consult a provider for proper diagnosis and treatment.

NIH: National Institute on Deafness and Other Communication Disorders (NIDCD)