Sleep Pattern Differences Between Older Adult Dementia Caregivers and Older Adult Noncaregivers Using Objective and Subjective Measures

Abstract

ScieNtific iNveStigAtioNSStudy objectives: Informal caregivers of persons with dementia often complain about poor quality sleep; however, studies on caregivers have mixed results when examining sleep values. The purpose of this study was to describe the sleep patterns in a subset of dementia caregivers who provide care during the night, and compare those patterns to noncaregiving adults. Methods: Data from a study on dementia caregivers and from a study of sleep in older adults were used. Both studies used objective and subjective methods to measure sleep in the home setting over a 7-day period. Participants were over 60 years old and relatively healthy. Results: Older dementia caregivers had worse objectively measured sleep than noncaregiving older adults, characterized by fewer minutes asleep and longer time to fall asleep. For subjectively measured sleep, depressive symptoms were the only predictive factor, with depressed participants reporting longer total sleep time, greater sleep onset la-tency, and wake after sleep onset. Caregivers' sleep had greater nightto-night variability. conclusions: Caregivers consistently report poorer quality sleep and greater fatigue than noncaregivers. However, when sleep is measured objectively and subjectively, a mixed picture emerges regarding sleep deficits. Thus sleep changes are caused by a multitude of factors affecting sleep in a variety of ways. It is important for health care providers to assess sleep adequacy and depression in caregivers.

Factors associated with sleep in family caregivers of individuals with dementia

“…Dissimilarly, in our study, the average sleep onset latency was longer than in previous studies. 9,45,46 Given the Approximately 67% of caregivers reported the use of sleep medications at least once during the past month. This rate is higher than rates reported in other sleep studies that found that the rates of sleep medication use in caregivers ranged from 38 to 42%.…”

“…First, symptoms of depression commonly experienced by caregivers are associated with disruptions in sleep. 5,8,9 Second, it is well established that individuals with dementia commonly experience sleep disruptions, and these disruptions are viewed as problematic by caregivers. 5,8 Finally, these factors could interact to form a self-perpetuating cycle of sleep disturbance.…”

Sleep Disturbance in Family Caregivers of Individuals With Dementia: A Review of the Literature

“…Eleven studies in our review included an agematched non-caregiver or/and a non-Alzheimer's caregiver comparison group to further examine sleep differences. Seven of them concluded that family caregivers had more disturbed sleep than non-caregivers (Cupidi et al, 2012;Lee, 2008;McKibbin et al, 2005;Mills et al, 2009;Rowe et al, 2008;von Kanel et al, 2010;Willette-Murphy et al, 2006), while the other four studies did not find a significant difference in sleep between groups. In the study conducted by Castro et al (2009), family caregivers reported having more symptoms of sleep disturbances than non-caregivers.…”

“…Two studies examined differences between caregiver and non-caregiver groups on daytime sleepiness, which indicates whether a person is obtaining adequate sleep or needs to improve sleep hygiene (Castro et al, 2009;Rowe et al, 2008). Daytime sleepiness was significantly higher in caregivers than non-caregivers (Rowe et al, 2008). Castro et al also found that caregivers' daytime sleepiness (ESS: 8.3 Ϯ 5.3) was higher than that of non-caregivers (ESS: 6.8 Ϯ 3.4); however, the difference was not statistically significant.…”

Sleep in Dementia Caregivers and the Effect of a Nighttime Monitoring System

“…The use of actigraphy in this project has been described elsewhere (Rowe, McCrae, Campbell, Benito, & Cheng, 2008). In summary, bedtime and out-of-bed were generally set by using the times listed in the caregiver's sleep diary.…”