Dementia caregiving takes toll on sleep

Family caregivers for dementia patients don't sleep as long or as well as other adults of the same age, a new study suggests.

In an analysis of the combined data from 35 earlier studies, researchers found that dementia caregivers slept about 3 hours less per week than age-matched adults, according to the report published in JAMA Network Open.

"Sleep debt is known to have cumulative associations with physical, mental and cognitive health," the researchers, led by Chenlu Gao wrote. "Therefore, poor sleep quality in dementia caregivers should be recognized and addressed."

To take a closer look at the impact of caregiving on sleep, the Gao and her colleagues scoured the medical literature for research on the topic. In the end they focused on 35 studies that looked at sleep problems in caregivers, including some that also considered the impact of therapy for the issue.

Sleep length and quality in those studies was measured either by polysomnography, which measures brain waves, wrist worn motion sensors or self-reported answers to questionnaires.

The combined studies included information on 3,268 caregivers, 76.7% of whom were women. When compared to age-matched non-caregiving adults, caregivers slept less - by an average of 2.42 hours to 3.5 hours per week - and had poorer sleep quality, including more difficulty falling asleep and disturbed sleep.

Among the 35 studies were 13 that looked at the impact of therapy for sleep problems in caregivers. Those studies showed that poor sleep could, indeed, be improved.

Just looking at the average difference in sleep over a week may be "misleading," said Stephen Smagula, an assistant professor of psychiatry and epidemiology at the University of Pittsburgh. "That comes down to about 25 minutes a day. But some caregivers may be really losing a lot of sleep while some aren't losing much," he added.

Bad sleep can lead to a host of health problems, Smagula said. "If you're losing a lot of sleep over a long period of time, you are at higher risk of heart disease, Alzheimer's, dementia, diabetes."

The new study "was not at all surprising" to Katherine Ornstein, an assistant professor of geriatrics and palliative care medicine at the Icahn School of Medicine at Mount Sinai in New York City. "We know caregivers are doing so much," she said. "They are caring for children, working, dealing with financial stress, their own health. So, of course sleep would be impacted in some way."

Sleep problems may be a more concrete way of looking at the extra burdens caregivers have taken on, Ornstein said.

The new findings are "really just one more reminder that we have to do more to support caregivers," Ornstein said. "That's the bottom line. We are completely reliant on them. And with dementia they are (caregiving) for longer periods of time."