“It’s Been a Hard Day’s Night”: Sleep Problems in Caregivers for Older Adults

Leggett, Amanda; Morley, Madelyn; Smagula, Stephen F.

doi:10.1007/s40675-020-00164-0

Cited by 8 publications

(5 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with research about negative health effects associated with sleep disorders, 2,16-19,39 hospice family caregivers with insomnia symptoms in our study rated their health significantly lower than caregivers without insomnia and over half (54%) reported feeling their own health had suffered due to caregiving. Given self-rated health predicts morbidity and mortality 40 and acute insomnia may become chronic, clinicians and policy makers should be concerned about family hospice family caregivers’ current and future mental and physical health needs.…”

Section: Discussionsupporting

confidence: 88%

“…8,10,[12][13][14] Poor sleep among caregivers contributes to racial, ethnic, and socioeconomic health disparities 15 and is associated with worse physical health, anxiety and depression, increased caregiver mortality, and lower caregiver QOL. 2,[16][17][18][19] In a recent mixed methods study, for example, 73% of hospice family caregivers described their sleep quality as "fair" or "poor" and 36% reported difficulty falling or staying asleep more than half the days of a week or more. 20 Anticipating and attending to care-recipient needs at night, 21,22 many hospice family caregivers report frequent sleep interruptions, awakenings, and anxiety that contributes to hyperarousal patterns, prevents restorative sleep, and results in daytime fatigue, poor mood regulation, and compromised work or caregiving performance.…”

Section: Introductionmentioning

confidence: 99%

“…8,10,12-14 Poor sleep among caregivers contributes to racial, ethnic, and socioeconomic health disparities 15 and is associated with worse physical health, anxiety and depression, increased caregiver mortality, and lower caregiver QOL. 2,16-19…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden

Starr

Washington

McPhillips

et al. 2022

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Background Poor sleep exacerbates mental health problems and reduces quality-of-life (QOL) but prevalence of insomnia symptoms among hospice family caregivers and associations of poor sleep with caregiver health and QOL outcomes are not known. Objective To describe prevalence of insomnia symptoms among hospice family caregivers and compare anxiety, depression, self-rated health, QOL, and caregiver burden between hospice family caregivers with and without insomnia symptoms. Methods Descriptive sub-study using data collected during baseline interviews of hospice family caregivers involved in a randomized clinical trial in Midwestern United States (xxxxxxxx). Caregivers were dichotomized based on Insomnia Severity Index (ISI) scores (8+ indicated insomnia symptoms). Results Among 57 hospice family caregivers, the mean ISI score was 8.2; nearly half (49.1%) experienced insomnia symptoms. Compared to caregivers without insomnia symptoms, caregivers with insomnia symptoms reported 2.4 times greater mean anxiety scores (4.7 vs 11.4); 3.5 times greater mean depression scores (3.1 vs 10.7); 2.1 times greater caregiver burden scores (5.6 vs 11.8); and 1.3 times lower self-rated health (3.5 vs 2.8); 1.3 times lower total QOL scores (29.3 vs 22.6); including differences in emotional QOL (7.9 vs 2.2), social QOL (7.2 vs 3.0), and physical QOL (7.4 vs 5.3). Conclusions Hospice family caregivers experience high prevalence of insomnia symptoms; caregivers with insomnia symptoms report worse anxiety, depression, caregiver burden, QOL, self-rated health. Clinicians must screen hospice caregivers for poor sleep and mental health and offer supportive interventions that improve their sleep and health. Policy makers must expand hospice benefits to better support family caregivers.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden

Starr

Washington

McPhillips

et al. 2022

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

“…22 As death approaches, family caregivers of home-based terminally-ill persons experience declines in sleep duration and increases in daytime dysfunction 22,27 and other negative effects, including worse physical health, anxiety and depression, increased caregiver mortality, lower caregiver quality of life, and greater caregiver burden. 21–23,28–30 Poor sleep during caregiving is well-documented, specifically among cancer caregivers, 22,24 but few studies have explored caregivers’ narrative experiences and perceptions of sleep during the period leading up to a patient’s death, when (sometimes scary) care needs intensify overnight and caregiver distress increases, 27,31 exacerbating already higher than average rates of anxiety, 26,32,33 depression, 26,32,33 and psychological distress 34 among hospice family caregivers. Given high prevalence of mental health disorders in hospice family caregivers and well-established relationships between mental health disorders and sleep disorders, 35–37 research is needed to understand how end-of-life family caregivers perceive their sleep experiences in the context of mental health, physical health, and functionality.…”

Section: Introductionmentioning

confidence: 99%

“It was terrible, I didn’t sleep for two years”: A mixed methods exploration of sleep and its effects among family caregivers of in-home hospice patients at end-of-life

et al. 2022

View full text Add to dashboard Cite

Background: Due to overnight caregiving demands; exacerbation of high rates of anxiety, depression, and distress; and inadequate support, millions of family caregivers of patients receiving in-home hospice are at risk of poor sleep and negative health effects. Aim: To describe sleep experiences of family caregivers of in-home hospice patients and perceptions of these experiences on caregivers’ wellbeing in the context of caregiver health and live-in status. Design: Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. Setting/participants: About 47 family caregivers of in-home hospice patients from two randomized clinical trials (NCT03712410, NCT02929108) were interviewed (United States, 2021). Anxiety (GAD-7), depression (PHQ-9), quality-of-life (QOL) (CQLI-R), and self-rated health and energy were reported prior to interviews. Results: Qualitative analysis revealed three themes: compromised sleep quality, factors influencing sleep, effects of sleep. 72.5% of hospice family caregivers described “fair” or “poor” sleep quality, with “ interrupted” sleep and frequent night-waking due to “ on-call” “ vigilance” and anxiety. Negative effects included exhaustion, mental and physical health decline, and reduced caregiver function. Live-in caregivers reported higher mean depression scores (8.4 vs 4.3, p = 0.08), higher mean anxiety scores (7.7 vs 3.3, p = 0.06), and lower mean QOL scores (24.8 vs 33.6, p < 0.001) than live-out caregivers. Anxiety, depression, and QOL worsened as self-reported caregiver sleep quality decreased. Few caregivers had adequate support. Conclusion: End-of-life family caregivers experience disrupted sleep with negative effects and inadequate support. Clinicians must assess sleep, offer sleep interventions, and provide more supports to hospice family caregivers.

show abstract

“…As the dementia symptoms worsen, the care required of family members becomes increasingly burdensome with potential to cause more stress, anxiety, depression and poor quality of life [5,10]. The burden of caring for people with dementia can lead to chronic sleep disturbances, further worsening their mental health, quality of life and work efficacy [11]. Moreover, caregivers have an increased risk of developing chronic conditions such as diabetes and cardiovascular disease and negative physiological changes in stress hormones levels and immune function may also ensue [12][13][14].…”

mentioning

confidence: 99%

Efficacy of yoga for caregivers of persons with dementia: An integrative review

Parkman

Olausson

2023

Scandinavian Caring Sciences

View full text Add to dashboard Cite

BackgroundThe progressive nature of dementia leaves the person vulnerable and dependent on others for care. While persons with dementia often have better outcomes when cared for at home, it can lead to personal challenges and self‐neglect of the caregiver. Mindfulness‐based interventions such as yoga can lessen the potential negative effects encountered by caregivers of persons with dementia.AimThe aim of this review was to synthesise available empirical research related to the role of yoga on the biopsychosocial health outcomes for caregivers of persons with dementia population.MethodA systematic search of the databases Academic Search Complete, CINAHL Plus, Medline and PsychINFO was done using the terms “yoga” AND “caregivers or family members or informal caregivers” AND “dementia or Alzheimer's.” Using the selection process outlined by the PRISMA framework, thirty‐six studies met the initial criteria and were potentially relevant to the topic. A methodological check was performed using the critical appraisal tool of Melnyk and Fineout‐Overholt and the GRADE system of recommendation. This process led to the inclusion of four articles.FindingsFour studies were included for this review: two randomised controlled trials, a non‐randomised intervention study with a waitlist and a pilot cohort study. Three studies focused on informal caregivers and one study involved professional caregivers. In all studies, yoga practices included asanas, pranayama, relaxation and meditation. This integrative review recommended that yoga may be useful in reducing stress, depression and anxiety while increasing quality of life indicators, vitality indicators, self‐compassion scores, mindfulness attention, sleep quality and diastolic blood pressure. Outcomes that were not significantly changed were caregiver burden, systolic blood pressure and heart rate. However, the level of evidence was moderate with small sample sizes suggesting additional research is needed to include well‐designed randomised controlled trials with larger sample sizes.

show abstract

“It’s Been a Hard Day’s Night”: Sleep Problems in Caregivers for Older Adults

Cited by 8 publications

References 40 publications

Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden

Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden

“It was terrible, I didn’t sleep for two years”: A mixed methods exploration of sleep and its effects among family caregivers of in-home hospice patients at end-of-life

Efficacy of yoga for caregivers of persons with dementia: An integrative review

Contact Info

Product

Resources

About