Family Caregivers of People with Dementia Have Poor Sleep Quality: A Nationwide Population-Based Study.

Min Ji Song,Ji Hyun Kim

doi:10.3390/ijerph182413079

Abstract

Previous studies have documented cognitive impairments, psychological stress, and depressive symptoms in family caregivers of people with dementia (PWD), which could be attributed to their sleep disturbances. Notwithstanding the increasing recognition of poor sleep quality and sleep disturbances in family caregivers of PWD, their association has not been tested yet using population-representative samples. We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2537 cohabitating caregivers of PWD, 8864 noncohabitating caregivers of PWD, and 190,278 non-caregivers. Two sets of multivariable logistic regressions were conducted to examine the associations between dementia caregiving and poor sleep quality in cohabitating and noncohabitating caregivers versus noncaregivers. Both cohabitating and noncohabitating caregivers had higher global PSQI scores and higher prevalence of poor sleep quality (PSQI score > 5) than did noncaregivers. Multivariable logistic regressions adjusted for potential confounders revealed that cohabitating caregivers (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.15–1.38) and noncohabitating caregivers (OR 1.15, CI 1.10–1.21) were significantly associated with poor sleep quality. Our results showed that both cohabitating and noncohabitating caregivers of PWD experienced overall poorer sleep quality compared to noncaregivers, indicating the deleterious effect of dementia caregiving on sleep quality, regardless of living arrangements. Given the high prevalence of poor sleep quality in family caregivers of PWD and the increasing awareness of the serious health consequences of poor-quality sleep, physicians should consider active sleep interventions to promote health and wellbeing not only for the dementia patients but also for family caregivers.

Highlights

Dementia affects approximately 47 million adults worldwide as of 2016 [1]
Poor sleep quality was more frequently observed in noncohabitating caregivers of people with dementia (PWD) than in noncaregivers, suggesting that having a dementia patient in the family could result in poorer sleep quality, irrespective of living arrangements
Caregivers of PWD experienced higher stress level and poorer health status compared to noncaregivers, further corroborating that dementia caregiving is associated with cognitive impairment and poor physical and psychological health statuses

Summary

Introduction

Dementia affects approximately 47 million adults worldwide as of 2016 [1]. The estimated number of people with dementia (PWD) in 2015 is approximately 0.6 million inSouth Korea, with this number expected to increase by 2030 to 1.3 million [1]. Dementia affects approximately 47 million adults worldwide as of 2016 [1]. The estimated number of people with dementia (PWD) in 2015 is approximately 0.6 million in. South Korea, with this number expected to increase by 2030 to 1.3 million [1]. Dementia poses a growing public health concern and is one of the leading causes of morbidity and mortality [2]. In 2013, the annual cost for dementia in South Korea was estimated to be about USD 10 billion, which represented approximately 0.7% of its gross domestic product [1]. Measurement of the disease burden by calculating disability-adjusted life years indicated that dementia is a very burdensome disease to PWD and to their family members and informal caregivers [2]. Informal caregiving of PWD frequently occurs over

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