Factors associated with sleep in family caregivers of individuals with dementia

Peng, Hsi-Ling; Lorenz, Rebecca; Chang, Yu Ping

doi:10.1111/ppc.12307

Cited by 50 publications

(50 citation statements)

References 54 publications

(113 reference statements)

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“…All previous international studies identified an average PSQI >/ 5 in dementia caregiver studies [15] highlighting the prevalence of the issue. As expected, and consistent with previous studies [13], Australian caregivers of PLWD have a high prevalence of poor sleep with 94% of participants classified as poor sleepers. The PSQI global score (9.12 ± 3.7) was higher than those found in some dementia caregiver studies [24,25] but comparable with others [13].…”

Section: Discussionsupporting

confidence: 92%

“…As expected, and consistent with previous studies [13], Australian caregivers of PLWD have a high prevalence of poor sleep with 94% of participants classified as poor sleepers. The PSQI global score (9.12 ± 3.7) was higher than those found in some dementia caregiver studies [24,25] but comparable with others [13]. The PSQI sub-components which greatest contributed to the overall score were sleep latency (time taken to fall asleep), sleep quality (overall subjective quality) and sleep disturbances.…”

Section: Discussionsupporting

confidence: 92%

“…Whilst providing this care can be highly rewarding, it has also been described as a chronic stressor with caregivers reporting low quality and quantity of sleep [11] and high levels of stress and depression [12]. In fact, sleep disruption is prevalent amongst dementia caregivers with over 90% of caregivers experiencing sleep disturbances [13].…”

Section: Introductionmentioning

confidence: 99%

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Disrupted sleep and associated factors in Australian dementia caregivers: a cross-sectional study

et al. 2020

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Background: Sleep disturbance is an issue reported by caregivers. Waking at night is a feature of dementia and by proxy, sleep disturbance among caregivers is reported to be high. Little is known about the characteristics of dementia caregivers' sleep and the factors that may influence sleep disruption. The purpose of this study was to investigate the sleep characteristics and disturbances of Australian caregivers of a person living with dementia. In addition, it evaluated the psychological wellbeing of caregivers by evaluating associations between mood and sleep in this population. Methods: This study used a cross-sectional, descriptive, correlation design. Participants were recruited with the assistance of Alzheimer's Australia, Dementia Australia and targeted social media advertising. In total, 104 adult, primary, informal caregivers of people with dementia participated, completing a questionnaire on demographic characteristics, the Depression, Anxiety and Stress Scale (DASS-21) and the Pittsburgh Sleep Quality Index (PSQI). Results: In this study, 76% of caregivers were female who had been caring for someone living with dementia on average for 4.8 years. 44% of participants had two or more co-morbidities namely cardiovascular disease, osteoarthritis and diabetes. 94% of participants were poor sleepers with 84% with difficulty initiating sleep and 72% reporting having difficulty maintaining sleep. Overall, psychological distress was common with high levels of moderate to severe depression, anxiety and stress. Global PSQI scores were significantly positively associated with depression and anxiety, with the strongest correlation seen with stress scores. Depression scores were also moderately associated with daytime dysfunction. Stress was identified as a significant predictor of overall sleep quality. Conclusions: Sleep problems are common within the population of dementia caregivers. Due to the nature and duration of caregiving and the progression of dementia of the care recipient, there is the potential for a decline in the caregivers' mental and physical health. Caregivers of those living with dementia are more likely to have comorbidities, depression, anxiety and stress. Sleep quality is correlated with emotional distress in dementia caregivers although the direction of this association is unclear. Therefore, sleep and psychological wellbeing may be intertwined, with improvements in one aspect resulting in a positive impact in the other.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Disrupted sleep and associated factors in Australian dementia caregivers: a cross-sectional study

et al. 2020

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“…It is important to deliver cost effective care which improves outcomes for people with dementia in clinical practice, 37 and is being used in recently published studies measuring sleep in people with dementia including a randomised controlled trial, 30,[38][39][40][41] these results will also be helpful for researchers to use in future studies.…”

Section: Discussionmentioning

confidence: 99%

The minimum clinically important difference on the sleep disorders inventory for people with dementia

Webster¹,

Martin²,

Livingston³

2020

Int J Geriat Psychiatry

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Objectives: Sleep disturbances in dementia causes distress to people with dementia and their family carers and are associated with care home admission. The Sleep Disorders Inventory (SDI) is a validated questionnaire of sleep disturbances in dementia often used to measure treatment effectiveness, but the minimum clinically important difference (MCID) is unknown. Methods: We triangulated three investigative methods to determine the MCID of the SDI. Using data on SDI from a randomised controlled trial (RCT) with 62 participants in an intervention for sleep disorders in dementia, we (1) calculated distribution-based values where MCID = 0.33 of a SD (SD) (2) an anchor based approach using quality of life (measured using DEMQOL-Proxy) as an anchor. We also employed a Delphi consensus process asking 12 clinicians, sleep researchers and family carers to rate which changes on vignettes were equivalent to a MCID. Results: We found that 0.33 SD in the SDI = 4.86. Reduction in SDI total score was not significantly correlated with improvement in DEMQOL-Proxy (Pearson's correlation = −0.01; P = 0.96) score. The Delphi consensus required two rounds to reach a consensus and concluded that changes equivalent to three points on the SDI equated to the MCID. Conclusions: Taking into account both the distribution-based values and the Delphi process we used a whole number at the midpoint and judged the minimum clinically

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“…Sleep disturbances increase the risk of obesity, diabetes, and cardiovascular diseases [6][7][8][9]. Features of sleep disorders among these caregivers include shortened sleep time, decreased sleep efficiency, wake after sleep onset (WASO), and less slow-wave sleep [10][11][12][13]. Nocturnal awakening is associated with the activation of sympathetic nerve activity [9].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Respite Care via Short-Stay Services to Support Sleep in Family Caregivers

Sakurai

Kohno

2020

IJERPH

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Family caregivers of older people who need care often experience sleep disorders, which can lead to various health problems. Although respite care is used in many countries, its effectiveness has not been fully demonstrated. We analyzed the sleep of family caregivers using actigraphy and heart rate spectral analysis to clarify changes in their sleep characteristics during short-stay respite care. Participants were all family caregivers living with an older person needing long-term care. The outcomes consisted of questionnaire responses, sleep/wake records, and R-wave to R-wave interval records. Quantitative evaluation of sleep revealed that caregivers’ median sleep time was 378.0 min, and median sleep efficiency was 94.7%. The low frequency (LF)/high frequency (HF) value was 1.722 for total sleep and 1.822 for the first half of the sleep period. The LF/HF for the first half of the sleep period was significantly different between caregiving and respite days. The respite day LF/HF was 1.567, which was significantly lower than on caregiving days. On respite days, cardiac sympathetic nervous activity among family caregivers was reduced during the first half of the sleep period. This suggests that regular use of short-stay services can improve caregivers’ sleep status, making this an effective form of respite care.

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Factors associated with sleep in family caregivers of individuals with dementia

Cited by 50 publications

References 54 publications

Disrupted sleep and associated factors in Australian dementia caregivers: a cross-sectional study

Disrupted sleep and associated factors in Australian dementia caregivers: a cross-sectional study

The minimum clinically important difference on the sleep disorders inventory for people with dementia

Effectiveness of Respite Care via Short-Stay Services to Support Sleep in Family Caregivers

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