Caregiver Reports of Sleep Problems in Non-Hispanic White, Hispanic, and African American Patients with Alzheimer Dementia

Abstract

Study Objectives: Sleep problems are common in persons with dementing illnesses and among the most stressful patient behaviors for caregivers. Although studies have shown differences in sleep across ethnic groups, little information is available on ethnic differences among persons with dementia. The purpose of this study was to investigate possible ethnic differences in sleep problems among patients with Alzheimer dementia. Method: Caregiver reports of 5 sleep-or circadian rhythm-related behavioral problems (behavior disturbance worse in the evening, difficulties falling asleep, frequent awakenings, early awakenings, and excessive daytime sleep) were evaluated in 395 patients who had received a diagnosis of Alzheimer disease after diagnostic evaluation. The average cognitive score of the groups suggested that they could be characterized as having moderately severe impairment. The frequency of sleep problems was then evaluated across subgroups defined by self-reported ethnicity (African American, Hispanic, and non-Hispanic white). As patient and caregiver characteristics may affect caregivers' reports of patients' behaviors, mixed effects regression models were used to adjust for patient and care-giver variables that might affect caregiver reports. Results: Analyses revealed ethnic differences in sleep or circadian rhythm disturbances. African American and Hispanic patients were reported to have more severe sleep disturbances than non-Hispanic whites. After correction for patient and caregiver variables that might have affected caregiver reports, differences between African Americans and others remained. Conclusions: Sleep problems in patients with dementing illnesses are reported by caregivers with differing frequencies across groups of African Americans, Hispanics, and non-Hispanic whites. Clinicians should be aware of these differences in assessing sleep disturbance in patients with dementia as well as the potential effects of patient and caregiver variables on reports of these problems.

Effect of caregiving status on the sleep of older New Zealanders

“…These findings corroborate previous research with younger Māori adults (aged 20–59 years). Ethnic disparities with regard to sleep health could be associated with sleep disordered breathing, physical and mental health, or SEP [9,15,19].…”

MicroRNAs: a potential interface between the circadian clock and human health

“…Interestingly, dysregulation of the clock also appears to contribute to disturbances of the sleep-wake cycles in individuals with Alzheimer's disease. These spontaneous night-time awakenings in patients with Alzheimer's disease are one of the most challenging issues for caregivers [ 42 ]. Likewise, individuals suffering from Huntington's disease exhibit clock-regulated disruption of neuroendocrine output, and of the sleep-wake cycles [ 43 - 45 ].…”

Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial

“…Informal caregivers have reported having severe back pain due to alterations in the trunk muscle extensor strength [8,20], and other osteomuscular disorders [4]. At the psychological level, it has been found that informal caregivers experience high levels of subjective burden, distress, and a wide variety of psychological disorders [5,13,21,[24][25][26][27][28][29], as well as sleep problems [30][31][32]. In addition, as part of their role, caregivers also suffer other symptoms such as hostility, aggression, somatization, irritability, hallucinations, delusions, restlessness, and disinhibition [2,[33][34][35].…”