Associations of self-reported and objectively measured sleep disturbances with depression among primary caregivers of children with disabilities

Abstract

ObjectiveThe objective of this study was to determine the association between sleep and depression using both self-reported (subjective) and actigraphic (objective) sleep traits.MethodsA cross-sectional study was conducted among 175 female primary caregivers of children with disabilities receiving care at a rehabilitation center in Punta Arenas, Chile. The eight-item Patient Health Questionnaire was used to ascertain participants’ depression status. The Pittsburgh Sleep Quality Index was used to define subjective, or perceived, sleep quality. Wrist-worn actigraph monitors, worn for seven consecutive nights, were used to characterize objective sleep quality and disturbances. Interviewer-administered questionnaires were used to collect information on sociodemographic and lifestyle factors. Linear regression models were fit using continuous sleep parameters as the dependent variables and depression status as the independent variable. Multivariable models were adjusted for body mass index, marital status, smoking status, education level, and children’s disabilities.ResultsUsing an eight-item Patient Health Questionnaire score ≥10, 26.3% of participants presented with depression. Depressed women were more likely to self-report overall poorer (subjective) sleep compared to non-depressed women; however, differences in sleep were not consistently noted using actigraphic (objective) sleep traits. Among the depressed, both sleep duration and total time in bed were significantly underestimated. In multivariable models, depression was negatively associated with sleep duration using both subjective (β=−0.71, standard error [SE] =0.25; P=0.006) and objective sleep (β=−0.42, SE =0.19; P=0.026).ConclusionThe association between sleep and depression differed comparing subjective and objective methods of assessment. Research strategies allowing for the integration of both perceived and objective measures of sleep traits are encouraged.

Sleep disturbances in caregivers of children with medical needs: A systematic review and meta-analysis.

“…Sleep efficiency was collected as part of the subjective PSQI (Orta et al, 2016) or using sleep diaries (Matthews et al, 2014) and/or based on objective measures (i.e., actigraphy and polysomnography; Macaulay et al, 2019; Meltzer, 2008; Orta et al, 2016). Sleep efficiency in caregivers ranged between 79% and 93% (Daniel et al, 2018; Feeley et al, 2019; Macaulay et al, 2019; Matthews et al, 2014).…”

Is aging a problem?: Dependency, long-term care, and public policies in Chile

“…The LTC perspective incorporates the idea of the patient-caregiver dyad, adding a new dimension to the problem. As in most countries around the world, caregivers in Chile have health issues (25–28), have fewer opportunities for paid work (3, 29, 30), and are mostly women (6, 31). This shows the existence of a clear gender bias in the LTC sphere.…”

<p>Personalized Sleep Parameters Estimation from Actigraphy: A Machine Learning Approach</p>

“…Sleep health plays a critical role in both physiological and psychological health. Poor sleep is associated with an increased chance of cardiovascular disease,1–4 Type 2 diabetes,5 cognitive problems,6 attention-deficit hyperactivity disorder (ADHD),7 depression, and performance 8–11. Addressing such problems requires reliable assessment of sleep 12–15.…”