Correlates of Sleep Disturbance Experienced by Informal Caregivers of Persons Living with Dementia: A Systematic Review

ABSTRACT

Objectives

This study aims to comprehensively review and update the literature concerning the correlates of sleep disturbance among caregivers of persons living with Alzheimer’s disease and related dementias to identify gaps in the literature and antecedent targets for interventions.

Methods

We searched PubMed, CINAHL, PsycINFO, and Embase using terms related to “sleep,” “caregiver,” and “dementia.”

Results

Thirty-six articles were included in this review. Based on the antecedents within the 3P model of insomnia, predisposing factors associated with caregiver sleep included caregiver demographics, and physiological factors like genotype and biomarkers. Precipitating factors related to caregiver sleep included caregiving status and responsibilities, and person living with dementia factors.

Conclusions

Sleep disturbance is a significant issue for caregivers of persons living with dementia. However, this review has identified multiple precipitating factors that are modifiable targets for interventions to improve or enhance caregiver sleep.

Clinical Implications

Numerous predisposing and precipitating factors contribute to caregivers of persons living with dementia being susceptible to sleep disturbance. Healthcare providers should ask patients about their caregiving status during annual visits. Healthcare providers should also evaluate caregivers’ sleep patterns, and the predisposing and precipitating factors of sleep disturbance, with a focus on the modifiable factors, to enable timely intervention.

KEYWORDS:

• Care partner
• cognitive impairment
• Alzheimer’s disease
• caregiver burden
• cognitive behavioral therapy for insomnia

Clinical implications

• Given the numerous caregiver risk factors and pervasive impact of poor sleep, healthcare providers should better identify those caregivers who currently have, or who are at risk for developing sleep disturbance.

• Caregiver sleep assessment should include questions about sleep patterns, and predisposing (e.g., age, gender) and precipitating (e.g., psychological symptoms, caregiver responsibilities, presence of behavioral and psychological symptoms of dementia) factors of poor sleep.

• Caregiver interventions like coping skills, pleasant activity scheduling, or activities to increase positive affect, which target the modifiable precipitating factors should be recommended to prevent or reduce the incidence of sleep disturbance.

Acknowledgments

We would like to thank Shenita Peterson, MPH, a public health informationist from Woodruff Health Sciences Center Library, who offered guidance regarding the search strategy.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Additional information

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Glenna S. Brewster was supported by a research supplement to support diversity in health-related research from the National Institute on Aging (R01AG054079, PIs: Hepburn/Griffiths), a K23 from the National Institute on Aging (K23AG070378), the Program to increase Diversity in Behavioral and Sleep Disorders Research (R25HL105444, PI: Jean-Louis/Ogedegbe, and a grant from the Alzheimer’s Association (2019-AARDG-643440); Dr. Miranda V. McPhillips was supported by a K23 from the National Institute of Nursing Research (K23NR018487); Dr. Fayron Epps was supported by a K23 from the National Institute on Aging (K23AG065452).