Sleep Health Barriers and Facilitators Among African American Family Caregivers

The cultural and historical experiences of African American family caregivers increase their risk for poor sleep health. Limited research representation hinders the development of effective sleep interventions for their unique needs. The purpose of this study is to explore the barriers and facilitators to sleep health in African American family caregivers and describe participants' preferences and recommendations for sleep health interventions.

Using a qualitative descriptive approach, African American family caregivers of community-dwelling adults with chronic or disabling conditions were recruited via community-based methods. Twenty-four caregivers participated in semi-structured in-person, telephone, or videoconference interviews. Transcribed interviews were analyzed using conventional content analysis.

Participants were on average 58 years old, mostly female (87.5%), and caring for a parent (79.2%). Caregivers reported significant sleep health barriers due to caregiving responsibilities, various sources of stress, and personal health problems such as anxiety or sleep apnea. Caregiving responsibilities disrupted sleep due to irregular sleep timing, night time interruptions from care recipients' needs, and hypervigilance to ensure care recipient safety. Sleep facilitators included accessing caregiving resources such as self-initiated proactive strategies to address care recipient needs and caregiving support from other family members. Caregivers also described how daytime activities, relaxation strategies, and natural or prescribed sleep aids helped improve their sleep. Lastly, caregivers suggested topics for intervention sessions and shared their preferences for intervention delivery.

Our findings inform the cultural adaptation of sleep health interventions for African American family caregivers to address stress reduction, caregiving support, and sleep apnea risk and treatment.