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.

Background Uncoupled sleep is a phenomenon characterised by a disconnect between sleep pattern and sleep complaint. This study examined the impact of uncoupled sleep on dysfunctional sleep beliefs and objective and subjective sleep outcomes in community‐dwelling older adults following digitally delivered Cognitive Behavioural Therapy for Insomnia (CBT‐I) to assess how these groups respond to CBT‐I. Methods Objective sleep was measured using wrist actigraphy, subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS‐16). All measurements were taken prior to and following a 4‐week online CBT‐I program. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS‐16 scores, respectively. Results Out of 80 enrolled participants, 62 participants (55 females, 89%; 16 complaining good sleepers, 26 complaining poor sleepers, 11 non‐complaining good sleepers, and nine non‐complaining poor sleepers) completed the study. CBT‐I reduced dysfunctional sleep beliefs across all sleeper classifications. Objective and self‐reported changes in sleep parameters were demonstrated in complaining poor sleepers without uncoupled sleep. Complaining good sleepers with uncoupled sleep only reported a decrease in the number of subjective sleep awakenings. There were no changes in sleep outcomes in non‐complaining good and non‐complaining poor sleepers. Conclusions Online CBT‐I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT‐I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT‐I in older adults will need to be conducted.

Objectives: Individuals who complain of insomnia may not always have objectively measured poor sleep, and vice versa, a phenomenon which is referred to as uncoupled sleepers. This study assessed the prevalence of uncoupled sleepers and levels of dysfunctional sleep beliefs in a sample of older adults in Western Australia.Method: 80 adults aged 60-80 years (71 females, 89%) completed a questionnaire, sleep diary and actigraphy measurements. Sleep related dysfunctional beliefs and self-rated sleep quality were assessed using the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16). Objective sleep quality was measured using an ActigraphTM model wGT3X-BT activity monitor and subjective sleep quality was assessed using a modified version of the Consensus Sleep Diary.Results: 52 of 80 participants (65%) were uncoupled sleepers. Individuals who complained of insomnia in the absence of objectively measured poor sleep showed worse self-reported sleep outcomes and higher dysfunctional beliefs, even though on actigraphy measurements there were no significant differences. Discussion: Future research should examine subjective and objective sleep parameters in older individuals. Interindividual differences in the relationship between perceived and measured sleep quality could present a target for potential therapeutic intervention.Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451

Background: Approximately 60% of adults over the age of 60 years report that they have trouble sleeping. Online Cognitive Behavioural Therapy for insomnia (CBT-I), an evidence-based form of talk therapy, is considered an effective treatment option. This feasibility study examined the suitability of an online CBT-I programme for older adults aged 60 -80 years in Western Australia.Methods: Participants with and without insomnia completed the first out of four online CBT-I modules and provided feedback via an online questionnaire regarding programme acceptability, utility and accessibility.Results: High approval ratings (91.7%) suggest that study participants believed the online CBT-I programme to be acceptable, useful and accessible, independent of their insomnia status. Potential areas for improvement were noted, including making the online programme more customisable and interactive.Conclusions: Findings from this feasibility study indicate that respondents viewed the online CBT-I programme as appropriate for adults aged 60-80 years. The full-scale study will subsequently be conducted without any protocol alterations.

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