Informal Care and Sleep Disturbance Among Caregivers in Paid Work: Longitudinal Analyses From a Large Community-Based Swedish Cohort Study

Abstract

Study ObjectivesTo examine cross-sectionally and prospectively whether informal caregiving is related to sleep disturbance among caregivers in paid work.MethodsParticipants (N = 21604) in paid work from the Swedish Longitudinal Occupational Survey of Health. Sleeping problems were measured with a validated scale of sleep disturbance (Karolinska Sleep Questionnaire). Random-effects modeling was used to examine the cross-sectional association between informal caregiving (self-reports: none, up to 5 hours per week, over 5 hours per week) and sleep disturbance. Potential sociodemographic and health confounders were controlled for and interactions between caregiving and gender included. Longitudinal random-effects modeling of the effects of changes in reported informal caregiving upon sleep disturbance and change in sleep disturbance was performed.ResultsIn multivariate analyses controlling for sociodemographics, health factors, and work hours, informal caregiving was associated cross-sectionally with sleep disturbance in a dose–response relationship (compared with no caregiving, up to 5 hours of caregiving: β = 0.03; 95% CI: 0.01, 0.06, and over 5 hours: β = 0.08; 95% CI: 0.02, 0.13), results which varied by gender. Cessation of caregiving was associated with reductions in sleep disturbance (β = −0.08; 95% CI: −0.13, −0.04).ConclusionsThis study provides evidence for a causal association of provision of informal care upon self-reported sleep disturbance. Even low-intensity care provision was related to sleep disturbance among this sample of carers in paid work. The results highlight the importance of addressing sleep disturbance in caregivers.

Co-resident care-giving and problematic sleep among older people: evidence from the UK Household Longitudinal Study

“…Null hypothesis 1 can therefore be rejected as co-resident care-givers had significantly higher odds of reporting problematic sleep after one year than those not providing care, independent of potential confounding variables. Studies using repeated measurements have found similar significant associations between care-giving and sleep over a period of seven days (Rowe et al, 2008) and two years (Sacco et al, 2018), though not among all studies (von Kaenel et al, 2012;Song et al, 2017). The present study found 27 per cent of co-resident care-givers suffered problematic sleep, in comparison to 24 per cent of non-care-givers (Table 2).…”

“…Transitions, and their influence on stress outcomes, is an important concept at the heart of the stress process (Pearlin, 2010). Previous research has found ceasing care-giving was associated with reduced sleep problems (Sacco et al, 2018), but von Kaenel et al (2012 found increased sleep disturbance after three months, where ceasing care-giving was as a result of spousal death. Our analyses found neither entering into care-giving nor ceasing care-giving had significantly different odds of reporting problematic sleep in the following year compared to non-care-givers.…”

“…Although ceasing care-giving has been associated with increased levels of distress (Hirst, 2005), evidence is mixed among care-givers who institutionalised the person they care for, with studies finding decreased levels of burden (Bleijlevens, 2014) yet also significant levels of anxiety and poor sleep (Washington et al, 2018). The analysis of von Kaenel et al (2012) of the impact of ceasing care-giving due to institutionalisation or death of the spouse, and the contrasting results of Sacco et al (2018) among younger working carers indicates a need for close attention to be paid to the characteristics of the care-giver and the circumstances of ceasing care. No significantly differing odds compared to non-care-givers may suggest ceasing care-giving alleviates any problems of physical night-time care or may indicate differing effects dependent on circumstance.…”

Reciprocal relations between work stress and insomnia symptoms: A prospective study

“…Future studies with denser measurements of both exposures from work environment factors as well as insomnia symptoms are needed. Potential confounding factors not included in this study are factors in private life, such as taking care of a partner (Sacco, Leineweber, & Platts, ) or children (Estrela, Barker, Lantagne, & Gouin, ).…”

Informal Caregiving, Chronic Physical Conditions, and Physical Multimorbidity in 48 Low- and Middle-Income Countries

“…Studies on multimorbidity are crucial as it is an important risk concept associated with increased disability ( 8 , 9 ), poorer quality of life ( 10 ), and premature mortality ( 11 ). Caregivers are known to be at increased risk of stress ( 12 ), sleep problems ( 13 ), and unhealthy behavior such as smoking ( 14 ) and lack of physical activity ( 15 ), and these may increase risk for multimorbidity. Moreover, one previous U.S. study including 359 spousal caregivers and care recipients found that caregivers with multiple chronic conditions had greater emotional and physical difficulties than those without multiple chronic conditions ( 16 ), underlying the point that the presence of multiple chronic conditions may favor the onset of negative care-related outcomes (eg, poor physical health, subjective burden, low care-related quality of life).…”