Objective: Falls in seniors due to sleep disorders in not uncommon. Identifying the underlying cause of these falls is essential for implementing appropriate preventive strategies.
Background: We describe five patients who often fell out of bed and were found to have obstructive sleep apnea (OSA) and body movements occurred only during NREM sleep and were associated with periodic limb movements (PLMS)-induced arousals through a sleep study (polysomnography (PSG) without loss of atonia in skeletal muscles occurred during REM sleep, and their complaints almost disappeared after they received continuous positive airway pressure (CPAP) treatment. This study delineates and enumerates the distinctive or significant aspects of such cases.
Method: A retrospective case series was conducted using data from our registry from patients who presented with recurrent falls during sleep and underwent Polysomnography. All patients underwent comprehensive neurological history taking and examination, brain imaging, and completed a detailed sleep questionnaire. Body mass index (BMI) was calculated for all participants. The Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and STOP-BANG questionnaire were administered.
Results: Polysomnography (PSG) revealed significant sleep-related abnormalities among the cases. In the first case, the apnea–hypopnea index (AHI) was 74.8/h. The second case demonstrated severe obstructive sleep apnea (OSA) with an AHI of 56/h; treatment with auto-adjusting positive airway pressure (APAP, 4–20 cm H₂O) resulted in a residual AHI of 2.0/h. The third case had severe OSA with an AHI of 82/h and showed significant improvement after treatment with auto-CPAP . The fourth case showed severe OSA (AHI 47.3/h) with coexisting periodic limb movements (PLM index 14.7/h). The fifth case had a normal AHI (3.2/h) but demonstrated excessive periodic limb movements consistent with primary periodic limb movement disorder with probable REM sleep behavior disorder (RBD)-like symptoms.
Conclusion: Falling out of bed in seniors may be due to pseudo RBD associated with OSA, and that a detailed sleep history and video PSG are crucial to confirm the diagnosis and to exclude other causes of falling out of bed for proper management of sleep disorders in this population.
To cite this abstract in AMA style:
R. Alloush, A. Mansour, A. Alloush, M. El-Shiek, T. Alloush. Sleep-related Falling Out of Bed in Elderly Patients: The Role of Obstructive Sleep Apnea [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/sleep-related-falling-out-of-bed-in-elderly-patients-the-role-of-obstructive-sleep-apnea/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-related-falling-out-of-bed-in-elderly-patients-the-role-of-obstructive-sleep-apnea/