Contributors to sleep disturbances in caregivers and care recipients with dementia

Abstract

AbstractBackgroundSleep disturbances in Alzheimer’s disease impact people with dementia (PWD) and caregivers (CGS) who have primary responsibility for care provision. However, it is unknown which aspects of dementia including cognitive decline and behavioral disturbance contribute most to sleep disturbances in patients and caregivers. This pilot study aims to discover what contributes most to sleep deficits, and whether these factors are consistent across both PWD and CGS.MethodPatients: Six dyads with PWD and their primary CGS. Cognitive/behavioral variables: the Montreal Cognitive Assessment (MoCA) (PWD) and the Neuropsychiatric Inventory Questionnaire (NPI‐Q) completed by CGS. Polysomnography: recorded and scored for 1 night for each dyad member separately. Actigraphy: Wrist actigraphy recorded for 14 days in both members of the dyad divided into fixed rest (2200‐0600) and activity (0600‐2200) periods. Sleep variables: total sleep time (TST), sleep onset latency (SOL), nighttime activity as measured by actigraphy.ResultPreliminary results indicate that severity of cognitive dysfunction measured by the MoCA correlates with sleep time (CG r = 0.6224, PWD r = 0.5421). However, presence of neuropsychiatric symptoms and caregiver distress as measured by the NPIQ correlate with sleep onset latency (CG r = 0.9432*, PWD r = 0.7819) and nighttime activity in both CGs and PWD (CG r = 0.8467, PWD r = 0.8708). * = p<0.05.ConclusionThis pilot study of six PWD/CGS dyads examines the relationship between cognition, behavioral disturbance, CGS response to the behavioral disturbance, and sleep. This data indicates that sleep disturbances in PWD and their CGs cannot be explained exclusively by worsening cognitive function and likely have stronger dependence on the neuropsychiatric well‐being of the PWD and CGS emotional response. This dyadic model is unique in that it looks at the interdependence of the PWD/CGS dyad using both objective measures of sleep, cognition, and behavioral disturbance as well as subjective CGS stress. Data from additional dyads is currently being collected to increase the sample size along with the inclusion of additional variables in order to increase understanding of the relationship between PWD characteristics, caregiver burden and sleep disturbances.