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Ogugu EG, Reilly MR, Mbe KTA, Bell JF. Habitual Sleep Duration and Health-Related Quality of Life in Family Caregivers: Findings from the Behavioral Risk Factor Surveillance System. Behav Sleep Med 2024; 22:499-515. [PMID: 38334029 DOI: 10.1080/15402002.2024.2314284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Insufficient sleep duration is associated with poor health-related quality of life (HRQoL). However, this relationship has not been studied in family caregivers, a group at high risk of insufficient sleep duration and poor HRQoL. OBJECTIVE To examine the associations between habitual sleep duration and HRQoL measures in family caregivers. METHODS This cross-sectional study used data from 23,321 caregivers in the 2016 Behavioral Risk Factor Surveillance System. The HRQoL measures were health status and poor mental and physical health days. A multivariable logistic regression model was used to assess the association between sleep duration (<7, 7-9, >9 hours) and health status (fair or poor versus good to excellent). Zero-inflated negative binomial models were used to analyze the association of sleep duration with poor mental and physical health days. RESULTS Fair or poor health status was significantly higher in caregivers with short (odds ratio [OR], 1.40; 95% CI: 1.12, 1.74) and long (OR, 2.07; 95% CI: 1.34, 3.21) sleep duration. Short sleep duration was associated with a higher number of poor mental health days (IRR [incident rate ratio], 1.17; 95% CI: 1.04, 1.31) and poor physical health days (IRR, 1.26; 95% CI: 1.10, 1.45). Long sleep duration was associated with more poor mental health days (IRR, 1.31; 95% CI: 1.08, 1.60). CONCLUSION Extremes in sleep duration were associated with lower HRQoL. These findings point to the need for interventions that promote adequate sleep and address factors underlying extremes in sleep duration in the context of family caregiving.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Maura R Reilly
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Kougang T Anne Mbe
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis, California, USA
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Gut microbiome and daytime function in Chinese patients with major depressive disorder. J Psychosom Res 2022; 157:110787. [PMID: 35344817 DOI: 10.1016/j.jpsychores.2022.110787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is underscored by daytime dysfunction-associated features, including mood disturbances, impaired cognition, fatigue, and daytime sleepiness. Importantly, the gut-brain axis may represent a potential mechanistic link between MDD and daytime dysfunction. Therefore, this study aimed to explore the gut microbiome composition and daytime dysfunction in Chinese patients with MDD. METHODS We enrolled 36 patients with MDD and 45 healthy controls (HCs) matched by age, sex, and body mass index (BMI). Daytime function including emotion, fatigue, and sleepiness were assessed using the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). 16S rRNA sequencing was employed to characterize the gut microbiota in stool samples. RESULTS The operational taxonomic units (OTUs) OTU255, OUT363 were positively correlated with HAMD and HAMA. OTU244, OTU542 and OTU221 were positively correlated with ESS, HAMD and HAMA. OTU725 and OTU80 were positively correlated with FSS, ESS, HAMD and HAMA, while OTU423 and OTU502 were negatively correlated with all above. Flavonifractor positively correlated with fatigue in patients with MDD and all individuals simultaneously. The correlation between gut microbiome and daytime function was different in MDD and HCs. CONCLUSIONS We identified several OTUs associated with the severity of fatigue, depression, daytime sleepiness and anxiety in all individuals. Our results revealed the differences in microbiome found between patients with MDD and HCs. These findings provide insights into the potential microbiota changes that occur in MDD, and will enable the development of specific therapeutic strategies for targeting the various symptoms of depression.
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Lee MH, Min A, Park C, Kim I. How Do Sleep Disturbances Relate to Daytime Functions, Care-related Quality of Life, and Parenting Interactions in Mothers of Children with Autism Spectrum Disorder? J Autism Dev Disord 2022:10.1007/s10803-022-05532-z. [PMID: 35441918 DOI: 10.1007/s10803-022-05532-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
Abstract
Sleep disturbance is prevalent in caregivers and associated with negative physical, mental, and functional outcomes. This study examined the effects of sleep disturbance on daytime functions (sleepiness, fatigue, mood, cognitive alertness), care-related quality of life, and daily parenting interactions in 20 mothers of children with autism spectrum disorder for 10 consecutive days using ecological momentary assessment design. Participants responded about daytime functions four times and care-related quality of life and daily parenting interactions once using an online survey. Sleep disturbance was significantly related to all daytime functions and frustration with childcare. Therefore, development of sleep hygiene interventions is warranted to effectively reduce the impact of sleep disturbance and enable these mothers to better tackle daily physical and mental challenges.
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Affiliation(s)
- Meen Hye Lee
- Department of Nursing, Gangneung-Wonju National University, Gangneung, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, United States
| | - Inah Kim
- School of Nursing, Duquesne University, Fisher Hall 510, 600 Forbes Avenue, 15282, Pittsburgh, PA, United States.
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Song Y, Carlson GC, McGowan SK, Fung CH, Josephson KR, Mitchell MN, McCurry SM, Teng E, Irwin MR, Alessi CA, Martin JL. Sleep Disruption Due to Stress in Women Veterans: A Comparison between Caregivers and Noncaregivers. Behav Sleep Med 2021; 19:243-254. [PMID: 32116050 PMCID: PMC7483161 DOI: 10.1080/15402002.2020.1732981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective/Background: Sleep problems are common in women and caregiving for an adult is a common role among women. However, the effects of caregiving on sleep and related daytime impairment are poorly understood among women veterans. This study compared stress-related sleep disturbances, insomnia symptoms, and sleep-related daytime impairment between women veterans who were caregivers and those who did not have a caregiving role. Participants: Of 12,225 women veterans who received care in one Veterans Administration Healthcare System, 1,457 completed data on a postal survey (mean age = 51.7 ± 15.9 years). Two hundred forty three (17%) respondents (mean age 53.8 ± 12.7 years) were caregivers for an adult, predominantly for a parent, providing transportation. Methods: The survey included items that addressed insomnia symptoms, total sleep time, sleep-related daytime impairments, caregiving characteristics, self-rated health, pain, stress, body mass index, and demographic information. Results: In adjusted analyses, caregiver status did not directly predict sleep complaints alone. However, in multiple regression analyses, being a caregiver (odds ratio 1.7, p = .001) significantly predicted stress-related sleep disturbance, even after adjusting for age, pain, self-rated health, and other characteristics. Furthermore, being a caregiver (β = 3.9, p = .031) significantly predicted more symptoms of sleep-related daytime impairment after adjusting for age, pain, self-rated health, and other factors. Conclusions: Compared to noncaregivers, women veterans who were caregivers for an adult were more likely to report stress causing poor sleep, and more daytime impairment due to poor sleep. These findings suggest the need to target stress and other factors when addressing sleep disturbance among women veterans who are caregivers.
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Affiliation(s)
- Yeonsu Song
- School of Nursing University of California , Los Angeles, California
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
- David Geffen School of Medicine, University of California , Los Angeles, California
| | - Gwendolyn C Carlson
- Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System , North Hills, California
| | - Sarah Kate McGowan
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
| | - Constance H Fung
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
- David Geffen School of Medicine, University of California , Los Angeles, California
| | - Karen R Josephson
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
| | - Michael N Mitchell
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
| | - Susan M McCurry
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington , Seattle, Washington
| | - Edmond Teng
- School of Medicine, Stanford University , Palo Alto, California
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California , Los Angeles, California
| | - Cathy A Alessi
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
- David Geffen School of Medicine, University of California , Los Angeles, California
| | - Jennifer L Martin
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System , North Hills, California
- David Geffen School of Medicine, University of California , Los Angeles, California
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Liu Y, Almeida DM, Rovine MJ, Zarit SH. Care Transitions and Adult Day Services Moderate the Longitudinal Links between Stress Biomarkers and Family Caregivers' Functional Health. Gerontology 2017; 63:538-549. [PMID: 28521309 DOI: 10.1159/000475557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stress biomarkers have been linked to health and well-being. There are, however, few studies on how dysregulation in the hypothalamic-pituitary-adrenal axis and sympathetic nervous system actually affects functional health of family caregivers of persons with dementia. Further, it is not clear whether and how factors affecting caregiving stressor exposures such as care transitions and adult day services (ADS) use may affect such association. OBJECTIVE First, to examine the association of daily stress biomarkers and functional health over time among family caregivers of persons with dementia. Second, to examine effects of care transitions and ADS use on the association between baseline stress biomarkers and functional health over time. METHODS At baseline, caregivers provided 5 saliva samples each day during an 8-day diary study, where all caregivers were having a varying number of ADS days per week. There were 2 longitudinal follow-ups at 6 and 12 months on ADS use, care transitions, and caregivers' functional health. The average daily total output across days was computed at baseline for salivary cortisol, the sulfated form of dehydroepiandrosterone (DHEA-s), and salivary alpha amylase (sAA), which were used as predictors of caregivers' longitudinal functional limitation trajectories. Care transitions and total number of ADS days per week at baseline were considered as moderators of the associations between stress biomarkers and health over time. RESULTS The associations between functional limitation trajectories and daily total outputs of cortisol and sAA were modified by ADS use and care transitions. Among caregivers who experienced a transition, and who used less than average ADS days per week, lower daily cortisol total output and lower daily sAA total output were associated with increasing functional limitations. Caregivers who experienced a transition but used greater than average ADS days per week did not show such patterns of association. No significant effect was found for DHEA-s. CONCLUSION The study contributes to an important but largely unanswered question regarding implications of stress biomarkers on functional health. Assessments of the association between stress biomarkers and health among family caregivers of persons with dementia need to consider changes in stressor exposures over time, such as care transitions and ADS use.
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Affiliation(s)
- Yin Liu
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
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