A Mixed-Methods Study of Daily Bedtime Routines of African American Family Caregivers

Bedtime routines are modifiable behaviors that can influence sleep health and may be shaped by cultural and caregiving experiences. African American adults experience poorer sleep outcomes, characterized by reduced sleep duration and diminished sleep quality relative to other racial and ethnic groups.

This convergent mixed-methods study explored the bedtime routine of African American family caregivers and examined whether bedtime activities differ by co-residence status.

Thirty African American family caregivers completed daily sleep diaries over a 7-day period, including a report on bedtime activities (quantitative approach). A subsample (n = 24) participated in follow-up interviews about their usual bedtime routine (qualitative approach). All participants indicated if they lived with the care recipient during the baseline visit. Quantitative data were analyzed using descriptive statistics and Mann-Whitney U-tests, and qualitative data were analyzed using content analysis.

Participants' mean age was 58 years. Most cared for a parent or parent-in-law, and most lived with the care recipient. The most prevalent bedtime activities were watching television and using electronic devices, while fewer participants participated in sleep-promoting activities such as reading or relaxation exercises. Qualitative results about usual bedtime routines included personal care activities, enjoyable activities, caregiving and household responsibilities, and sleep preparation routines. Quantitative and qualitative results aligned on the most reported activities. Caregivers living with the care recipient reported fewer bedtime activities.

The results emphasize potential targets for interventions that are designed to enhance the sleep health of African American family caregivers by implementing practical and culturally relevant relaxing bedtime routines.