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Brantner CL, Bentley JP, Roth DL. Subtypes of Transitions into a Family Caregiving Role: A Latent Class Analysis. J Appl Gerontol 2024; 43:374-385. [PMID: 37990505 PMCID: PMC10923009 DOI: 10.1177/07334648231210680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
This paper groups persons who have transitioned into family caregiving using a latent class analysis and examines class differences on measures of well-being. Latent classes were identified for a sample of 251 participants who became family caregivers while participating in a longitudinal national study, and linear regression analyses compared average well-being change scores across classes. Fit indices supported a four-class solution dispersed along two conceptual dimensions: caregiving intensity and caregiving stain. The largest class (35.5%) was characterized as low intensity, low strain. The smallest class (12.7%) was characterized as high intensity, high strain, and these caregivers had significantly worse well-being change scores compared to the other caregiving classes. Categorizing caregivers by differing levels of care intensity and caregiving strain helps identify caregivers who are at most risk for poor psychosocial outcomes, determines which caregivers might benefit from specific caregiver support programs, and informs investigators on possible refinements to interventions.
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Affiliation(s)
- Carly L. Brantner
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John P. Bentley
- Department of Pharmacy Administration and Center for Pharmaceutical Marketing and Management, School of Pharmacy, University of Mississippi, University, MS, USA
| | - David L. Roth
- Center on Aging and Health, Division of Geriatrics and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Czeisler MÉ, Weaver MD, Robbins R, Barger LK, Varma P, Quan SF, Lane RI, Howard ME, Rajaratnam SMW, Czeisler CA. Sleep and mental health among unpaid caregivers of children, adults, and both: United States, 2022. Sleep Health 2024; 10:S201-S207. [PMID: 37770250 DOI: 10.1016/j.sleh.2023.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/02/2023] [Accepted: 08/21/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES We sought to characterize sleep and mental health, and their relationship, among unpaid caregivers. METHODS During March through August 2022, four waves of cross-sectional surveys were administered to US adults using demographic quota sampling and weighting to improve representativeness of the US adult population. RESULTS Among 19,767 respondents, 6260 (31.7%) identified as serving one or more unpaid caregiving roles. Compared to people without caregiving roles, caregivers more commonly reported sleep duration outside the healthy range (7-9 hours), insomnia symptoms, diagnosed sleep disorders, and more commonly screened positive for anxiety, depression, and burnout symptoms. Multivariable analyses adjusted for demographics characteristics revealed unpaid caregivers had several-fold elevated odds of adverse mental health symptoms; associations were attenuated but remained significant after adjusting for impaired and nonoptimal sleep. CONCLUSIONS Both sleep and mental health challenges are disproportionately experienced by and commonly co-occur among unpaid caregivers, especially those who care for both children and adults. These populations, which serve critical societal roles, may benefit from enhanced support services to address sleep and mental health.
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Affiliation(s)
- Mark É Czeisler
- Francis Weld Peabody Society, Harvard Medical School, Boston, Massachusetts, USA; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
| | - Matthew D Weaver
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Prerna Varma
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rashon I Lane
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Sutter Health, Sacramento, California, USA
| | - Mark E Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles A Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Monteiro BCDC, dos Santos TTBA, Nogueira MML, Dourado MCN. The relationship between burden and caregiver's sleep disturbances in dementia: a systematic review. Dement Neuropsychol 2023; 17:e20230030. [PMID: 38111593 PMCID: PMC10727027 DOI: 10.1590/1980-5764-dn-2023-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/27/2023] [Accepted: 09/24/2023] [Indexed: 12/20/2023] Open
Abstract
Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep. Objective This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances. Methods This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022. Results A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems. Conclusion Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.
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Affiliation(s)
| | | | - Marcela Moreira Lima Nogueira
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer, Rio de Janeiro RJ, Brazil
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Ahn S, Chung ML, Logan JG. Sleep Deficiency by Caregiving Status: Findings From Nationally Representative Data. West J Nurs Res 2023; 45:1120-1129. [PMID: 37902143 PMCID: PMC11298120 DOI: 10.1177/01939459231208416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Caregiving demands may influence caregivers' sleep duration and quality, which are essential for optimal health. We aimed to examine the association between caregiving status and sleep deficiency (i.e., short sleep duration and/or poor quality) and identify factors associated with sleep deficiency among caregivers. METHODS This secondary analysis used data from 3870 adults living in the United States, obtained from the 2019 Health Information National Trends Survey. Multinomial logistic regressions were performed to examine the association between caregiving status (i.e., caregivers vs. non-caregivers) and sleep status (i.e., normal duration-good quality [optimal sleep, reference], short duration-good quality, normal duration-poor quality, and short duration-poor quality), and to identify caregiving-related factors associated with sleep deficiency in the caregiver group. RESULTS Compared to non-caregivers, caregivers were more likely to report short sleep duration (<7 hours) with good quality sleep (relative risk ratio [RRR] = 1.566, 95% CI [1.238, 1.980]) or poor quality sleep (RRR = 1.376, 95% CI [1.034, 1.832]) than the optimal sleep status. Caregivers providing care for ≥20 hours per week (vs. <20 hours) and providing care to individuals with dementia (vs. no dementia caregiving) were 2.8 times more likely to report normal sleep duration with poor sleep quality than optimal sleep (RRR = 2.796, 95% CI [1.125, 6.950]; RRR = 2.776, 95% CI [1.154, 6.675], respectively). CONCLUSION The findings of a higher risk of sleep deficiency among caregivers suggest that health care providers need to assess both caregivers' sleep duration and quality status. Interventions tailored to the caregiving context are also warranted.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Misook L. Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Jeongok G. Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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