Sleep Quality In Caregivers Research Articles

The effect of the COVID-19 pandemic on the caregiving burden of individuals caring for patients with chronic neurological diseases.

Caring for neurological patients poses a serious burden on caregivers, even in normal times. It is likely that this burden has become even more painful post-COVID-19 pandemic. This study evaluates the effect of the COVID-19 pandemic on the care burden of those who care for patients with chronic neurological diseases. The study included 50 patients and 50 caregivers. All the tests were conducted twice, it was answered firstly, according to the pre-COVID-19 pandemic, and secondly, during the COVID-19 pandemic period. The depression levels of the patients and caregivers were assessed with the Beck Depression Scale, their sleep quality with the Pittsburgh Sleep Quality Index, their quality of life was assessed with the RAND 36-Item Health Survey, and caregivers' burden of care was evaluated with the Zarit Caregiver Burden Scale. It was observed at the end of the study that the depression levels of patients (p = 0.00), and caregivers (p = 0.00) increased post-COVID-19 pandemic, the sleep quality of caregivers (p = 0.00), and patients (p = 0.02) decreased post-COVID-19 pandemic. On the other hand, it was determined that caregivers' burden of care increased (p = 0.00). Sub-parameters of the RAND 36-Item Health Survey, physical functioning (p = 0.02), role limitations due to physical health (p = 0.00), and role limitations due to emotional problems (p = 0.03) decreased for caregivers. In summary, we concluded that the well-being and psychological status of both patients and their caregivers were adversely affected by the COVID-19 pandemic.

Sleep patterns of children with Cri du Chat syndrome before and during the COVID-19 pandemic: An observational study

BackgroundSleep patterns in children with Cri du Chat syndrome (CDC) remain understudied. The pandemic and isolation disrupted routines, potentially affecting their sleep. MethodsWe compared the sleep characteristics of 53 children with CDC before and during the COVID-19-related social isolation periods with that of 106 children with autism spectrum disorder (ASD) and 160 without either condition (comparison group), using the adapted Brief Infant Sleep Questionnaire (BISQ). The variables wake after sleep onset (WASO), awakenings, environment, strategies, and sleep latency were dichotomized based on relevant outcomes. Binomial logistic models were used for binomial outcomes and the lowest Akaike Information Criteria determined total sleep time distribution. Generalized estimating equations examined pandemic effects and intergroup differences. Multinomial regressions assessed pandemic and disorder impact on child and caregiver sleep quality. ResultsChildren with CDC had higher WASO, awakenings, and poorer sleep compared with the ASD and comparison groups in the pre-pandemic assessment DiscussionThese findings emphasize the importance of addressing sleep impairment in children with CDC to improve their overall well-being, both during exceptional circumstances like the pandemic and in their daily routines. The study provides valuable insights into sleep patterns and highlights the impact of the pandemic on sleep quality in different neurodevelopmental populations.

Sleep quality differences among caregivers for persons living with and without dementia

Objectives This study examined the relationship between caring for a person with/without dementia and caregiver sleep quality, and analyzed the extent to which perceived benefits of caregiving and assessments of caregiver-recipient relationship quality explain the relationship between care recipient dementia status and caregiver sleep quality. Method Data were analyzed from caregivers for persons with no or probable dementia who participated in the 2017 National Study of Caregiving (NSOC) and National Health and Aging Trends Study. Caregiver sleep quality was measured using NSOC time diary interview. Perceptions of caregiving and relationship quality were assessed using 4-item surveys. We used multivariable logistic regressions to examine the association between care recipient dementia status and caregiver sleep quality controlling for covariates. Results The sample consisted of 1,374 caregivers (mean age = 62.3, SD = 14, 68.3% women, 69.4% non-Hispanic White). In multivariable models adjusting for caregiver and care recipient characteristics, being a caregiver for someone with dementia was associated with 23% lower odds of reporting “excellent/very good” sleep quality (OR: 0.77, 95%CI: 0.61-0.98, p = 0.032). Greater perception of caregiving benefits was associated with 8% greater odds of “excellent/very good” sleep quality (AOR: 1.08, 95%CI: 1.02-1.15, p = 0.013), but did not explain the relationship between dementia and caregiver sleep quality. Positive ratings of relationship quality explained the relationship between care recipient dementia status and caregiver sleep quality (AOR: 0.82, 95%CI: 0.65-1.05, p = 0.12). Conclusion Improving assessments of relationship quality and amplifying perceptions of caregiving benefits may reduce disparities in sleep quality between caregivers of persons living with or without dementia.

0386 Feasibility of a Hypnosis Intervention for Sleep Quality in Caregivers of Individuals with Alzheimer's Disease

0386 Feasibility of a Hypnosis Intervention for Sleep Quality in Caregivers of Individuals with Alzheimer's Disease

Is caregiver sleep quality an important clinical issue?

Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. The participants were divided into two groups: the caregivers and the control group. The caregiver groups were categorized into two subgroups: family and paid caregivers. The sleep quality of the caregivers was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The demographics, body mass index, educational level, the presence of chronic diseases and medications, need for spiritual support, daytime sleepiness, duration of caregiving, nighttime awakening, and tea/coffee consumption were recorded. The study included 250 caregivers (female: 74.8%, mean age: 50.6 ± 12.1) and 103 control group members. Family caregivers significantly had an advanced age, lower educational level, more chronic diseases, and medications, need for spiritual support, and longer duration of caregiving compared to the paid caregivers (p = 0.018, < 0.001, 0.001, 0.005, < 0.001, and 0.003, respectively). The total PSQI scores of caregivers were significantly higher in the FDR, family group, females, those with need of spiritual support, and tea/coffee consumption close to bedtime (p = 0.002 < 0.004. 0.026. < 0.001, and 0.022, respectively). The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery. The provision of care by paid professional caregivers will improve quality of care and quality of life.

UNVEILING THE COMPLEX REALITIES: UNDERSTANDING SLEEP AND FATIGUE CHARACTERISTICS OF END-OF-LIFE CAREGIVERS

Abstract This mixed methods multi-case study explores sleep and fatigue characteristics among end-of-life caregivers. The research sample encompasses cases aiding individuals with advanced (n=4) and chronic illnesses (n=1), including various caregiver demographics such as gender, age groups (19-64 and 65+), and health conditions. Data collection involves comprehensive surveys capturing demographics, care recipient symptom intensity, caregiver depressive symptoms, caregiving stress, caregiver sleep quality, and caregiver fatigue level. The study integrates data from a 30-day Personal Sleep Monitoring Device (PSMD) and a 14-day sleep journal, enriched by insights from semi-structured interviews and field notes. The outcomes indicate a PSQI (Pittsburgh Sleep Quality Index) score of 6.1, accompanied by 7.44 hours of sleep recorded by the PSMD. There were approximately 20.5 nocturnal awakenings within 30 days, with average fatigue at 55.28 and daily fatigue at 49.66. Objective sleep outcomes were consistent among caregivers, while their own sleep ratings ranged from “Fairly Bad” to “Very Good.” Themes for each case were formulated to delve into the context of these sleep and fatigue characteristics. These themes encompass adaptive leadership, linchpin roles, emotional labor management, self-reliance, and vigilance. A prevailing overarching theme is the perception of “Not having control.” A significant finding underscores the dynamic influence of care recipients’ daily statuses on caregivers’ sleep quality and fatigue levels, leading to unpredictable outcomes. This study offers profound insights into end-of-life caregivers’ intricate journeys, highlighting individual differences and the dynamic nature of caregiving roles, while recognizing the importance of tailored interventions for enhancing caregiver’s well-being and caregiving effectiveness.

EXAMINING DIFFERENCES IN SLEEP QUALITY AMONG CAREGIVERS FOR PERSONS LIVING WITH AND WITHOUT DEMENTIA

Abstract Sleep disturbances among caregivers are linked to increased burden and worse mental health outcomes. Caregivers for persons living with dementia experience more sleep disturbances than non-caregivers. Few studies examine whether sleep quality differs between dementia and non-dementia caregivers. This study analyzes whether dementia caregivers experience worse sleep quality than non-dementia caregivers. Using 2017 National Study of Caregiving, National Health and Aging Trends Study, and time diary interview data, we examined the relationship between caregiver sleep quality (“excellent/very good” versus “good/fair/poor” the previous night) and care recipient’s dementia status (“probable” versus “no”) for 1,374 caregivers in a series of nested multi-variable logistic regression models, controlling for the caregiver and care recipient sociodemographic characteristics, relationship quality, and other controls. Caregivers’ mean age was 62.3 years old (SD=14) and about two-thirds were women (68%), non-Hispanic White (69.4%), and married (66%) Thirty-eight percent cared for persons living with dementia. In the bivariate model, being a caregiver for someone living with dementia was associated with significantly lower odds of reporting “excellent/very good” sleep quality (OR: 0.78, 95%CI: 0.62-0.97, p=0.02). This relationship persisted independent of caregiver and care recipient demographic characteristics. However, caregiver perceptions of the quality of their relationship with the care recipient and the benefits of their caregiving role explained the relationship between care recipient dementia status and caregiver sleep quality ratings (AOR: 0.80, 95%CI: 0.63-1.02, p=0.08). Addressing caregiver burden and relationship quality may help improve sleep quality among dementia caregivers and reduce disparities in sleep quality between dementia and non-dementia caregivers.

EXPLORING THE LINK BETWEEN SLEEP AND DEMENTIA: MULTIFACETED APPROACHES

Abstract Sleep and sleep quality have been linked to cognitive function over time. The quality of caregiver sleep can also affect their ability to function and provide support to persons living with dementia. This symposium leverages longitudinal survey data from two large US population-based surveys: the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC). This symposium aims to explore the relationship between sleep, cognitive function, and care activities for older adults living with and without dementia and their caregivers. First, Dr. Petrovsky will report findings that examined the relationship between caregiver sleep quality and persons living with dementia status using NHATS and NSOC data. Next, Dr. Esiaka will present cross-sectional findings from examining the relationship between older adult sleep quality, neighborhood disorder, and cognitive function using the NHATS data. Drs. Klingman and Sullivan will present the results of an analysis comparing the relationship between sleep and frequent hospitalization in persons living with dementia and those without dementia. Collectively, these papers will report on findings examining how a potentially modifiable factor, sleep, relates to cognitive function and caregiving.

74 Neurobehavioral Symptoms of Dementia as a Risk Factor for Poor Caregiver Sleep Quality

Objective:Caregivers to persons with dementia (PWD) consistently report lower sleep quality than non-caregiving controls. Low sleep quality, in addition to being unhealthy for the caregiver, may also impact the quality of care provided to the PWD. One factor that may contribute to poor sleep among caregivers is neurobehavioral symptoms (NBS) of the PWD. NBS, such as mood changes, lack of motivation, and disinhibition, are consistently rated as some of the most distressing symptoms by caregivers. Furthermore, they can include some symptoms related to sleep, such as nighttime wandering and REM sleep behaviors. Prior correlational research indicates a very strong association between NBS of the PWD and sleep quality of the caregiver. However, there are third variables, particularly demographics of the caregiver, which may better explain this relationship. When these variables are controlled in research, findings on the association between PWD NBS and caregiver sleep quality are mixed. Thus, we sought to investigate the relation between PWD NBS and caregiver sleep quality while controlling for caregiver demographics.Participants and Methods:Fifty caregivers to PWD completed a survey containing the Mild Behavioral Impairment Checklist as a measure of PWD NBS, the Pittsburgh Sleep Quality Index as a measure of caregiver sleep quality, and caregiver demographics. The relationship between PWD NBS and caregiver sleep quality was assessed using hierarchical linear regression. First, we examined the relationship between caregiver demographics (age, gender, income) and caregiver sleep quality. Second, we added NBS to the model to assess for incremental predictive utility by examining change in R2.Results:A significant correlation was found between PWD NBS and caregiver sleep quality, with higher PWD NBS associated with worse caregiver sleep quality (r(48) = .34, p = .014). A hierarchal regression found that caregiver demographics explained a non-significant proportion of variance in reported caregiver sleep quality (F(3, 44) = 1.05, p = .382, R2 = .07). When PWD NBS was added in model two, there was a significant change in variance explained in the overall model (F(1,43) = 2.65, p = .046, AR2 = .13, R2 = .20). Across both models, PWD NBS was the only variable significantly associated with caregiver sleep quality (B = .08, p = .011).Conclusions:In line with previous studies, these results indicate a moderate relationship between PWD NBS and caregiver sleep quality. Furthermore, findings suggested that PWD NBS is a risk factor for poor caregiver sleep quality, above and beyond caregiver demographic characteristics. Individuals designing interventions aimed at improving caregiver sleep quality should consider including PWD NBS as an intervention target. Future research should replicate these findings in a longitudinal sample to further evaluate causality.

Sleep Location and Its Association with Caregiver Sleep Quality During Patient Hospital Admission.

During acute hospitalization, many caregivers decide to stay at the care recipient's bedside over the course of several days or months, coping with a stressful situation and a poor sleeping environment. Our objective was to characterize caregiver sleep-wake cycles during care recipient hospital admission and test the association between sleep location (home versus hospital) and caregiver sleep. Eighty-six informal caregivers (78.8% female; age 55.47 ± 12.43 years) were recruited. For seven consecutive days, caregivers wore actigraphy devices and filled a sleep diary indicating whether they had slept at the hospital or at home. Caregiver insomnia symptoms, anxiety, and depression along with patient dependence were also assessed. Nighttime total sleep time, wake after sleep onset, sleep efficiency, sleep latency, and fragmentation index were described. Mixed-model analyses were used to evaluate the effect of the overnight location (home versus hospital) on caregiver sleep quality. In total, 38.4% of caregivers exhibited poor objective sleep efficiencies (< 80%), and 43% of caregivers reported having moderate to severe insomnia symptoms. Caregivers mostly slept at the hospital (n = 53), but some slept at home (n = 14) or between both locations (n = 19). Mixed-model analyses using actigraphy showed that caregivers had significantly better sleep quality when resting at home regarding wake after sleep onset, fragmentation index, and sleep efficiency (p < .05). Caregivers experienced poor sleep quality during care recipients' hospitalization, specifically when sleeping at the hospital versus sleeping at home. Healthcare workers should ensure caregivers' well-being and strongly encourage caregivers to rest at home whenever possible.

Relationship between traits and sleep quality of hospitalized elderly patients and sleep quality of family caregivers.

To understand whether the sleep quality of the caregivers of elderly inpatients is associated with their own characteristics and with the characteristics or sleep quality of the elderly inpatients. A cross-sectional study design that recruited participants from September to December 2020 was adopted, in which 106 pairs of elderly inpatients and caregivers were recruited. Data collected from the elderly inpatients included demographic characteristics as well as the numerical rating scale (NRS) score, Charlson Comorbidity Index (CCI), Geriatric Depression Scale Short Form (GDS-SF) score, and Pittsburgh Sleep Quality Index (PSQI). Caregiver data included demographic characteristics and PSQI. In the regression analysis of caregiver characteristics and caregiver sleep quality, only caregiver age and the relationship between caregiver and inpatient (other vs. spouse) were correlated with caregiver sleep quality. In the regression analysis of elderly inpatient characteristics, caregiver characteristics, and caregiver sleep quality, only the PSQI of elderly inpatients and the relationship between caregiver and inpatient (other vs. spouse) were correlated with caregiver sleep quality. Poor caregiver sleep quality was more likely to manifest when the elderly inpatients had poor sleep quality, when the caregivers themselves were older, and when the caregiver was the inpatient's spouse.

Sleep Quality in Caregivers of Pediatric Patients with Type 1 Diabetes Mellitus: The Impact of Flash Glucose Monitoring Systems with Alarms

Sleep Quality in Caregivers of Pediatric Patients with Type 1 Diabetes Mellitus: The Impact of Flash Glucose Monitoring Systems with Alarms

Correlation between burden and sleep quality in informal caregivers of infants with orofacial cleft.

To evaluate the correlation between burden and sleep quality in caregivers of infants with cleft lip and/or palate. This descriptive cross-sectional study was carried out in a Brazilian tertiary public hospital between March and September 2020. The sample included the main informal, literate caregivers of infants with cleft lip and/or palate, aged 18 years or older. The instruments used were the Burden Interview Scale and the Pittsburgh Sleep Quality Index. Data were collected during the infants' hospitalization. Statistical analysis adopted Pearson and Spearman correlations, with a 5% significance level. A total of 31 informal caregivers participated in the study, most of them mothers (n=28; 90%), with a mean age of 30 years (standard deviation - SD=7.5), low socioeconomic status (n=20; 64%), who completed high school (n=19; 61%), were married (58%), had two children (n=15; 48%), and no employment relationship (n=18; 58%). A moderate correlation was found between sleep quality and burden (r=0.39; p=0.032) and between burden and subjective sleep quality (r=0.39; p=0.029), sleep latency (r=0.43; p=0.017), and daytime dysfunction (r=0.49; p<0.001). The study showed that the higher the burden, the lower the sleep quality. The findings indicate the need to plan and implement interventions to minimize the burden experienced by these informal caregivers in order to improve their sleep quality.

Factorial Structure and Psychometric Properties of the Spanish Version of the Pittsburgh Sleep Quality Index in Non-Professional Caregivers.

Although sleep issues are among the symptoms commonly experienced by the non-professional caregiver population, and the Pittsburgh Sleep Quality Index (PSQI) is the most widely used instrument for the assessment of sleep quality, this has not been validated specifically for this population. The objective of this study was to analyze the factorial structure and psychometric properties of the Spanish version of the PSQI in a sample of Spanish non-professional caregivers. Trained clinical psychologists assessed sleep quality using the PSQI, as well as caregiver burden and psychological distress in 201 non-professional caregivers (87.1% female, Mage = 56.2 years). The internal consistency of the PSQI was 0.75. The two-factor model (Sleep quality and Disturbances) had an acceptable fit to the data, was found to be superior to the one-factor model, and more parsimonious than the three-factor model. There was a significant correlation between the PSQI and caregiver burden, as well as between the PSQI and psychological distress (p < 0.001 in all cases). A total score ≥ 9 allowed the identification of caregivers with possible anxiety and depression disorders (sensitivity 70.5%, specificity 71.9%). The results show that the PSQI is a reliable and valid instrument for the assessment of sleep quality in caregivers.

An Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Pilot Study.

The current study sought to pilot test and examine the effects of an integrative stress reduction program (ISRP) on caregiver stress and sleep quality and behavioral and psychological symptoms of dementia (BPSD) of care recipients. Family caregivers (N = 12) of persons with moderate to severe dementia were recruited from memory clinics in Thailand. Twelve caregivers participated in five educational sessions on dementia care, stress, and BPSD management over 4 weeks. The Relative Stress Scale and Pittsburgh Sleep Quality Index were used to measure caregiver outcomes. The Neuropsychiatric Inventory was used to measure BPSD of care recipients. Outcome variables were collected at baseline, postintervention, and follow up. Data were analyzed using one-way repeated measures analysis of variance. Participants reported statistically decreased stress, improved sleep quality, and decreased BPSD among care recipients postintervention and at follow up (all p < 0.001). The ISRP was feasible and shows promise in reducing stress and improving sleep quality in caregivers and lessening BPSD in care recipients. [Journal of Gerontological Nursing, 48(10), 26-32.].

“It was terrible, I didn’t sleep for two years”: A mixed methods exploration of sleep and its effects among family caregivers of in-home hospice patients at end-of-life

Background: Due to overnight caregiving demands; exacerbation of high rates of anxiety, depression, and distress; and inadequate support, millions of family caregivers of patients receiving in-home hospice are at risk of poor sleep and negative health effects. Aim: To describe sleep experiences of family caregivers of in-home hospice patients and perceptions of these experiences on caregivers’ wellbeing in the context of caregiver health and live-in status. Design: Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. Setting/participants: About 47 family caregivers of in-home hospice patients from two randomized clinical trials (NCT03712410, NCT02929108) were interviewed (United States, 2021). Anxiety (GAD-7), depression (PHQ-9), quality-of-life (QOL) (CQLI-R), and self-rated health and energy were reported prior to interviews. Results: Qualitative analysis revealed three themes: compromised sleep quality, factors influencing sleep, effects of sleep. 72.5% of hospice family caregivers described “fair” or “poor” sleep quality, with “interrupted” sleep and frequent night-waking due to “on-call” “vigilance” and anxiety. Negative effects included exhaustion, mental and physical health decline, and reduced caregiver function. Live-in caregivers reported higher mean depression scores (8.4 vs 4.3, p = 0.08), higher mean anxiety scores (7.7 vs 3.3, p = 0.06), and lower mean QOL scores (24.8 vs 33.6, p < 0.001) than live-out caregivers. Anxiety, depression, and QOL worsened as self-reported caregiver sleep quality decreased. Few caregivers had adequate support. Conclusion: End-of-life family caregivers experience disrupted sleep with negative effects and inadequate support. Clinicians must assess sleep, offer sleep interventions, and provide more supports to hospice family caregivers.

Effect of Children’s Autism Spectrum Disorder Severity on Family Strain and Sleep Quality: A Cross-Sectional Online Survey in the U.S.

To better understand the impact of children’s autism spectrum disorder (ASD) severity on families, we evaluated pathways through which ASD severity affected child sleep quality, caregiver strain, and caregiver sleep quality. In a cross-sectional analysis through the U.S.-wide Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Participants were caregivers of dependents with ASD aged 3–17 years (N = 3150). We found that increased severity strongly affects caregiver strain and child sleep quality. Child sleep quality was a minor mediator of increasing caregiver strain. Caregiver sleep quality depended on ASD severity only through child sleep quality and caregiver strain. Interventions aimed at improving child sleep quality or reducing caregiver strain could positively impact families of children with ASD.

Sleep quality in caregivers of patients with end-stage renal disease.

The aim of this study was to evaluate the self-reported quality of sleep among caregivers of patients who are receiving hemodialysis (HD) and peritoneal dialysis (PD). In 64 caregivers of patients of the University General Hospital of Evros in Northeastern Greece, who were receiving HD and PD, the following instruments were administered: Pitsburgh Sleep Quality Index (PSQI), Zung Depression Rating Scale (ZDRS), Self-Anxiety Scale (SAS), Well - Being Index (WHO- 5). The mean PSQI value of caregivers was 5.27 ±3.40 and 39% of them had poor sleep quality. "Poor sleepers" had significantly lower levels of quality of life (p=0.02), elevated levels of anxiety (p=0.006) and higher scores in the depression scale (p=0.009) compared to "good sleepers". In the regression analysis depression was found to have the greatest contribution to the variability of 'sleep quality' (standardized beta = 0.62, p<0.001) and quality of sleep seemed to improve as years of dialysis that the patient underwent increased (standardized beta = -0.28, p=0.007). Physicians should screen caregivers' sleep quality, especially during the first stages of the illness.

Assessing quality of sleep in caregivers of paediatric patients diagnosed with various hematology and oncology conditions: Preliminary findings

Assessing quality of sleep in caregivers of paediatric patients diagnosed with various hematology and oncology conditions: Preliminary findings

Stres dan Kualitas Tidur Caregiver dalam Merawat Pasien Skizofrenia di Poliklinik RSJ Bina Karsa Kota Medan

Family caregiver is the primary care provider for family members with spesific illness. It is often the caregiver experiences stress and sleep disturbances during the caregiving process. This research is a descriptive study which aims to analyze the stress and sleep quality of caregivers in caring for schizophrenia patients at the Polyclinic of the Bina Karsa Psychiatric Hospital / RSJ Bina Karsa Kota Medan. The study population was 442 caregiver patients with schizophrenia who accompanied the patient routine control from April to May 2019. 40 samples were involved with purposive sampling technique. The criteria of caregiver for schizophrenia patients were the family caregiver (father, mother, children, siblings, husband/wife etc.), provide care for 1-4 years, lived in Medan and patients is the recurrent patients. The instruments in this study were a demographic data questionnaire, a DASS 42 (Depression Anxiety Stress Scale) questionnaire and an SQQ (Sleep Quality Questionnary) questionnaire. The collected data were then analyzed by descriptive test, Annova test, and Kruskal Walis test. Based on the results of this study, the majority of respondents experienced mild stress 28 people (70%) with an average length of stay of 1 year and 3 months. For the quality of sleep experienced by the caregiver, data was obtained that 24 respondents (60%) experienced poor sleep quality and only 2 respondents (5%) experienced good sleep quality. In 2 respondents who had good sleep quality, the average length of stay was 3 years, 24 respondents had poor sleep quality, the average length of stay was 2 years 5 months, 14 respondents had adequate sleep quality, and the average length of stay was 1 year 10 months. The results of this study can be used as basic data for further assessment of caregivers who are often not a priority in health service policies.