Caregiver outcomes related to sleep disturbances in persons living with cognitive impairment

Sleep disturbances in persons living with cognitive impairment (PLWCI) may impose a great burden on caregivers. We examined the association between sleep (objective sleep quality and quantity; subjective sleep impairment, quality, and daytime sleepiness) in PLWCI and caregiver depression, mastery, and burden via secondary analysis of Healthy Patterns baseline data (n = 209). Objective sleep variables included total sleep time and sleep efficiency derived from PLWCI using 3 nights of actigraphy. Subjective sleep measures included PROMIS Sleep Related Impairment, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale, filled out by the caregiver describing the PLWCI sleep. Caregiver measures included Center for Epidemiological Studies Depression Scale, Caregiver Mastery Scale and Zarit Burden Interview. PLWCI were primarily female (66.5%) and Black (64%), with a mean age of 73.6 ± 8.6. Caregivers were mainly female (81%) and family caregivers (67%), with a mean age of 56.6 ± 14.7. After controlling for PLWCI cognition, age, and gender, poorer PLWCI sleep quality was significantly associated with more caregiver depression (β = 0.387, p = 0.029); worse PLWCI sleep impairment was associated with worse mastery (β = 0.104, p = 0.004). Poor PLWCI sleep quality was associated with lower caregiver mastery; the effect was larger for females than males. PLWCI being less sleepy during the day (β = 0.104, p = 0.055) and having worse sleep impairment (β =-0.163, p = 0.039) were both associated with more caregiver burden. There is a critical need to address the effects of PLWCI sleep disruption on caregivers in dementia care services.