Quantifying caregiver sleep disturbances using a dyadic model of dementia

Abstract

AbstractBackgroundSleep disturbances including insomnia, poor sleep quality, and sleep fragmentation appear to play a role in the development and progression of Alzheimer’s disease (AD) in older adults, but may also affect the health of caregivers. The purpose of this pilot study was to objectively quantify daily rest: activity patterns and polysomnography of the sleep of people with dementia (PWD) and their caregivers (CGS).MethodParticipants: Six dyads with PWD and their primary CGS. Actigraphy: Wrist actigraphy recorded for 14 days divided into fixed rest (2200‐0600) and activity (0600‐2200) periods. Polysomnography: recorded and scored for 1 night for each dyad member separately. Variables: sleep onset latency (SOL), total sleep time (TST).ResultAverage activity measures showed no differences within dyads for average daytime or nighttime activity, indicating the activity levels of CGS are highly reflective of the activity of their PWD partners. Despite similar activity levels, CGS displayed sleep deficits compared to their partners, with significantly increased SOL (p = 0.004). Additionally, with the exclusion of one outlier, all CGS received less TST than their demented partners. These deficits were present even when sleeping separately from their partners.ConclusionThe main findings of this pilot dyadic study reveal that the daily rest:activity patterns of CGS reflect that of their partners. Importantly, despite similar day‐ and nighttime activity, CGS had worse overall sleep than their demented partners, with lowered TST and significantly increased SOL. These findings occurred even when dyads were sleeping separately, indicating that sleep disruptions in CGS cannot be exclusively attributed to nighttime activity of the PWD. Our dyadic model currently is being applied to studies with larger sample sizes in order to determine the impacts of caregiving on sleep.