Predictors of Sleep Quality in Spouse Caregivers of Community-Dwelling People With Dementia Using Propensity Score Matching Analysis

Overview

Journal J Nurs Res

Specialty Nursing

Date 2023 Nov 14

PMID 37962915

Authors

Hyeon Sik Chu

Hye-Young Jang

Affiliations

Soon will be listed here.

Abstract

Background: Many family caregivers of people with dementia (PwDs) have sleep problems and poor sleep quality. Sleep may be negatively affected by caring for a family member with dementia, especially a spouse.

Purpose: This study was designed to assess sleep quality in spouse caregivers of PwDs and determine the impact of care provision on their sleep quality.

Methods: A secondary analysis of 58,050 participants in the 2018 Korea Community Health Survey was conducted. To prevent selection bias, a propensity score matching analysis was performed. Multiple logistic regression analysis was conducted to investigate the predictors of sleep quality.

Results: After obtaining a propensity score matching threshold of 3:1, the percentage of poor sleepers was 24.2% in the control group and 33.3% in the spouse-caregiver group, which indicates a significant difference (χ 2 = 11.79, p = .001). After adjusting for depressive symptoms in the multiple logistic analyses, no intergroup difference was found in terms of risk of poor sleep quality (odds ratio = 1.12, 95% CI [0.90, 1.61]).

Conclusions/implications For Practice: The findings of this study support that spouse caregivers of PwDs have poorer sleep quality than their nonspouse peers and that management of depressive symptoms is important to improving the sleep quality of spouses providing care to PwDs. Nursing interventions such as light therapy and exposure to sunlight during daytime hours to both improve sleep quality and reduce depressive symptoms can improve sleep quality in this vulnerable caregiver group.

References

Fernandez-Puerta L, Prados G, Jimenez-Mejias E . Interventions that Improve Sleep in Caregivers of Adult Care-Recipients: A Systematic Review. West J Nurs Res. 2021; 44(2):180-199. DOI: 10.1177/0193945921995477. View

Jang H, Yi M . [Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home]. J Korean Acad Nurs. 2017; 47(3):367-379. DOI: 10.4040/jkan.2017.47.3.367. View

Sohn S, Kim D, Lee M, Cho Y . The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath. 2011; 16(3):803-12. DOI: 10.1007/s11325-011-0579-9. View

Gottschalk S, Konig H, Brettschneider C . The association between informal caregiving and behavioral risk factors: a cross-sectional study. Int J Public Health. 2020; 65(6):911-921. PMC: 7426287. DOI: 10.1007/s00038-020-01402-6. View

Andreakou M, Papadopoulos A, Panagiotakos D, Niakas D . Assessment of Health-Related Quality of Life for Caregivers of Alzheimer's Disease Patients. Int J Alzheimers Dis. 2017; 2016:9213968. PMC: 5204092. DOI: 10.1155/2016/9213968. View

von Kanel R, Mausbach B, Ancoli-Israel S, Dimsdale J, Mills P, Patterson T . Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep. Sleep. 2012; 35(2):247-55. PMC: 3250364. DOI: 10.5665/sleep.1632. View

Brown M, Cohen S . Informal Caregiving, Poor Mental Health, and Subjective Cognitive Decline: Results From a Population-Based Sample. J Gerontol Nurs. 2020; 46(12):31-41. PMC: 8045765. DOI: 10.3928/00989134-20201106-04. View

McCurry S, Logsdon R, Teri L, Vitiello M . Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. Sleep Med Rev. 2007; 11(2):143-53. PMC: 1861844. DOI: 10.1016/j.smrv.2006.09.002. View

Jessen F, Amariglio R, van Boxtel M, Breteler M, Ceccaldi M, Chetelat G . A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimers Dement. 2014; 10(6):844-52. PMC: 4317324. DOI: 10.1016/j.jalz.2014.01.001. View

10.

Polenick C, Leggett A, Maust D, Kales H . Medical Care Tasks among Spousal Dementia Caregivers: Links to Care-Related Sleep Disturbances. Am J Geriatr Psychiatry. 2018; 26(5):589-597. PMC: 5940559. DOI: 10.1016/j.jagp.2018.01.206. View

11.

Khanassov V, Rojas-Rozo L, Sourial R, Yang X, Vedel I . Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec. BMC Fam Pract. 2021; 22(1):186. PMC: 8441033. DOI: 10.1186/s12875-021-01528-3. View

12.

Byun E, Lerdal A, Gay C, Lee K . How Adult Caregiving Impacts Sleep: a Systematic Review. Curr Sleep Med Rep. 2019; 2(4):191-205. PMC: 6508862. DOI: 10.1007/s40675-016-0058-8. View

13.

Joling K, van Marwijk H, Veldhuijzen A, van der Horst H, Scheltens P, Smit F . The two-year incidence of depression and anxiety disorders in spousal caregivers of persons with dementia: who is at the greatest risk?. Am J Geriatr Psychiatry. 2014; 23(3):293-303. DOI: 10.1016/j.jagp.2014.05.005. View

14.

von Kanel R, Dimsdale J, Ancoli-Israel S, Mills P, Patterson T, McKibbin C . Poor sleep is associated with higher plasma proinflammatory cytokine interleukin-6 and procoagulant marker fibrin D-dimer in older caregivers of people with Alzheimer's disease. J Am Geriatr Soc. 2006; 54(3):431-7. DOI: 10.1111/j.1532-5415.2005.00642.x. View

15.

Simpson C, Carter P . Dementia caregivers' lived experience of sleep. Clin Nurse Spec. 2013; 27(6):298-306. DOI: 10.1097/NUR.0b013e3182a87287. View

16.

Han C, Jo S, Kwak J, Pae C, Steffens D, Jo I . Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study. Compr Psychiatry. 2008; 49(2):218-23. DOI: 10.1016/j.comppsych.2007.08.006. View

17.

Kang Y, Ko Y, Kim Y, Sung K, Kim H, Choi H . Korea Community Health Survey Data Profiles. Osong Public Health Res Perspect. 2015; 6(3):211-7. PMC: 4551141. DOI: 10.1016/j.phrp.2015.05.003. View

18.

Prince M, Ali G, Guerchet M, Prina A, Albanese E, Wu Y . Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther. 2016; 8(1):23. PMC: 4967299. DOI: 10.1186/s13195-016-0188-8. View

19.

Joo H, Joo J, Kwon J, Jang B, Park E . Association between quality and duration of sleep and subjective cognitive decline: a cross-sectional study in South Korea. Sci Rep. 2021; 11(1):16989. PMC: 8379242. DOI: 10.1038/s41598-021-96453-x. View

20.

Carpenter C, Miller M, Sui X, West D . Weight Status and Sedentary Behavior of Alzheimer's Disease Caregivers. Am J Health Behav. 2019; 44(1):3-12. DOI: 10.5993/AJHB.44.1.1. View