Article2007

Sleep Problems in Elderly Women Caregivers Depend on the Level of Depressive Symptoms: Results of the Caregiver–Study of Osteoporotic Fractures

Jinesh Kochar · Lisa Fredman · Katie L. Stone · Jane A. Cauley

62 citations0/0 files storedJournal of the American Geriatrics Society

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Abstract

OBJECTIVES: To determine whether depressive symptoms modify the association between caregiving and sleep problems in elderly women. DESIGN: Cross-sectional study conducted in four communities in 1999 to 2001. SETTING: Home-based interviewer-administered questionnaires. PARTICIPANTS: Three hundred seventy-five caregiver and 694 noncaregiver participants from the Study of Osteoporotic Fractures. MEASUREMENTS: Self-reported frequency of three sleep problems in the previous month: trouble falling asleep, trouble staying asleep, and waking early and having trouble falling back asleep. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D), excluding the sleep disturbance item. RESULTS: In adjusted analyses, caregivers did not report more sleep problems than noncaregivers, although respondents with high depressive symptoms (CES-D > or = 16) were twice as likely to report each sleep problem. When depressive symptoms and caregiving were considered together, caregivers with high depressive symptoms were most likely to report sleep problems (adjusted odds ratios ranging from 2.5, 95% confidence interval (CI)=1.2-5.2 for trouble falling asleep to 4.0, 95% CI=2.0-7.8 for waking early, compared with nondepressed noncaregivers). By contrast, there was no difference in sleep problems between caregivers and noncaregivers who were not depressed. The combination of high depressive symptoms and high-stress caregiving situations (e.g., caring for a spouse or a person with dementia, or living with the care recipient) also increased the likelihood of sleep problems. CONCLUSION: Caregivers with high levels of depressive symptoms reported sleep problems more than nondepressed noncaregivers. These results underscore the importance of screening elderly female caregivers for depressive symptoms and sleep problems.

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References

1977The CES-D Scale 1977ASSESSING DEPRESSIVE SYMPTOMS IN FIVE PSYCHIATRIC POPULATIONS: A VALIDATION STUDY 2004Sleep disturbances and chronic disease in older adults 2004Associations of frequent sleep insufficiency with health-related quality of life and health behaviors 2006Poor Sleep Is Associated with Higher Plasma Proinflammatory Cytokine Interleukin‐6 and Procoagulant Marker Fibrin D‐Dimer in Older Caregivers of People with Alzheimer's Disease 1999Sleep Complaints in Older Women Who Are Family Caregivers 1998Successful Behavioral Treatment for Reported Sleep Problems in Elderly Caregivers of Dementia Patients: A Controlled Study 2006Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers.

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2009Insomnia in Caregivers of Persons with Dementia: Who is at Risk and What Can be Done About It?

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