Factors Related to Sleep Disturbances for Informal Carers of Individuals With PD and Dyadic Relationship: A Rural Perspective

Abstract

This study examines factors related to sleep disturbances, and the dyadic sleep relationship, in a convenience sample of 29 persons with Parkinson disease (PD) and spouse carer dyads living in regional Queensland. Carers completed questionnaires on sleep, depression, anxiety, carer burden, and well-being. Regarding carers, 66% reported sleep disturbances related to nocturnally care demands. Less than half of informal carers with a disturbed sleep had informed a health professional of this problem. Medication was the most commonly advised sleep intervention (44%). Sleep disturbances in informal carers correlated with increasing carer burden, depression scores, anxiety scores, poor quality of life, negative cognitions related to their sleep disturbance, and poor sleep hygiene. Regarding patient-carer dyads, 59% reported both the individuals having problematic sleep disturbances. Patient sleep disturbance correlated with informal carer increase in depression and anxiety scores, and poor carer burden. Informal carer’s sleep disturbance correlated with patient anxiety scores and severity of complications from PD therapy. Evidence-based sleep interventions addressing such dyads in rural areas warrant future study.

Sleep disturbance in caregivers of individuals with Parkinsonism: a systematic review and meta-analysis

“…Caregivers also reported that they experienced sleep disruption due to care recipients’ night-time sleep symptoms such as hallucinations, delusions, agitation and unsettled behaviours 37. These findings are consistent with a study that reported 93% of caregivers report sleep disturbance, with the most common reason for disturbance being the care recipient Parkinson’s symptoms 47. In addition, another study found a statistically significant difference in caregiver sleep disturbances between caregivers who had sufficient health/social access and those who did not 29…”

“… 30 38 44 45 In addition, two of these studies found that caregiver sleep quality was also associated with care recipient depression scores. 30 44 When considering caregiver burden, greater levels of burden and caregiver distress are associated with decreased self-report sleep duration, 36 increased sleep disturbance 47 and sleep problems. 45 This may also be true for sleep quality, in which increased caregiver burden and higher severity of motor symptoms in Parkinson’s care recipient was associated with an increased odds of poor sleep.…”

“…The average time since publication for included studies was 8.7 years, with a range of 0–24 years. The majority of studies (78%, n=14) were of cross-sectional design,30 33 36–47 with the remaining 22% (n=4) using a case–control design with healthy, non-caregiving controls 29 48–50 Table 3. summarises key sample characteristics of included studies.…”

“…All studies used subjective measures of caregiver sleep and none measured caregiver sleep objectively (eg, actigraphy, polysomnography). The PSQI31 was the most commonly used measure, being used in 28% (n=5) of studies 33 40 44 47 48. One study used both the PSQI44 and the validated General Sleep Questionnaire 51.…”

“…37 These findings are consistent with a study that reported 93% of caregivers report sleep disturbance, with the most common reason for disturbance being the care recipient Parkinson's symptoms. 47 In addition, another study found a statistically significant difference in caregiver sleep disturbances between caregivers who had sufficient health/social access and those who did not. 29 Few studies reported associations between caregiver characteristics and sleep.…”