Dyadic effects of distress on sleep duration in advanced cancer patients and spouse caregivers

Abstract

Objective Short sleep duration is a common problem for both advanced cancer patients and their spouse caregivers. Sleep and distress have been shown to be interdependent in patient‐caregiver and spouse dyads, yet virtually, no work has explored the dyadic effects of psychological distress on sleep in advanced cancer patients and spouse caregivers. The goal of the present study was to examine the dyadic impact of anxiety and depression on sleep duration in a sample of advanced cancer patients and their spouse caregivers. It was hypothesized that, for both patients and caregivers, anxiety and depression in individuals would be associated with sleep duration in both themselves (actor effects) and in their spouses (partner effects). Method Advanced cancer patients and their spouse caregivers (N = 87 dyads) completed cross‐sectional questionnaires assessing demographic variables, subjective health, subjective sleep duration, and anxiety and depression symptoms. Results Controlling for sex, age, and subjective health, individuals' anxiety was negatively associated with their own and their partner's sleep duration. No significant actor or partner effects were found for depression. Conclusions Results provided partial support for hypotheses. Although past work has demonstrated links between subjective sleep disturbance and anxiety/psychological distress, this is one of the first studies to examine partner effects of distress on sleep disturbance in advanced cancer patients and spouse caregivers.

Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature

“…Patients' pain 10 and symptom severity 48,49 were associated with caregivers' depression, 10,48,49 anxiety, 48 or distress 50 . Patients' sleep duration was affected by caregivers' anxiety 42 . Caregivers' psychological morbidity appeared to be directly related to patients' physical morbidity, 5,47 and (in one case) predicted patients' physical health decline 39 .…”

“…Four studies 37‐40 (17.4%) included patients with various cancer types, whereas 19 (82.6%) studies narrowed their sample by recruiting patients with either a specific cancer type 5,10,30‐36,41,43‐47,49,50 or in one case, a few specific types 42 . There were 12 cross‐sectional observational, 5,10,30,32,34,35,39‐42,44‐46,48 6 longitudinal, 5,31,36,39,43,49 2 mixed methods, 30,47 2 qualitative, 33,40 and 1 retrospective study 50 . Fifteen studies (65.2%) were conducted in the United States, 5,10,30,32‐34,39‐47 while 8 (34.8%) were international.…”

“…These associations were not found among dyads in which wives had cancer and husbands were caregivers. Otto et al 42 found that patients' anxiety predicted caregivers' shorter sleep duration, even after controlling for the caregivers' own anxiety.…”

“…This phenomenon was illuminated by interdependence findings among patients' physical and caregivers' psychological morbidity. However, interdependence between patients' psychological and caregivers' physical morbidity was least supported; only two studies 39,42 found significance. Of note is that Litzelman et al 39 had the largest sample of any study in this systematic review.…”

“…Studies' findings by category were not always in agreement. There was, however support for patients' and caregivers' interdependent psychological health at many points along the cancer trajectory, 5,33,34,39‐43,45‐47 suggesting that psychological interdependence can occur at various times. A cyclical feedback loop among dyads facing cancer, through which psychological issues in one individual may pose a risk for psychological issues in the other, may be theorized.…”