Informal caregiving linked to sleep problems

For people who are in the workforce already, the added burden of unpaid caregiving for a family member or loved one may lead to insomnia and other sleep issues, according to a large study from Sweden.

Researchers found that the likelihood of sleep problems rose with the number of hours spent in unpaid caregiving, and when caregiving stopped, sleep disturbances were reduced.

"Informal caregiving is common, and the need for carers is expected to grow due to population aging and cuts to social care services in various countries," said lead study author Lawrence Sacco of the Institute of Gerontology at King's College London in the UK.

Caregivers often face conflicting schedules and feel a sense of obligation, leaving some with little or no choice about when and how to help loved ones, he noted.

"Sleeping problems are common and deserve attention because people with insomnia are more likely to suffer from other physical illnesses," Sacco told Reuters Health by email. "Sleep disturbance and tiredness are also symptoms of depression and other mood disorders."

Sacco and his colleagues at the Stress Research Institute at Stockholm University analysed responses from 12,200 participants in the Swedish Longitudinal Occupational Survey of Health, a questionnaire mailed every two years to employed residents of Sweden aged 16 to 64. The researchers focused on surveys in 2010 through 2016.

They defined informal caregivers as those who, without pay, help or care for an elderly, ill or disabled relative other than a child or grandchild. Participants were asked how many hours they typically spend on this caregiving each week.

They were also asked how often in the prior three months they had difficulties falling asleep, repeated awakenings, premature awakenings or restless sleep.

About 85 per cent of the survey participants were not caregivers, while 12 per cent spent 1 to 5 hours providing care each week and 2 per cent spent anywhere from 6 to 15 hours caregiving.

After adjusting for social and economic factors, as well as the caregiver's own health status, the researchers found that sleep problems were more common among caregivers overall, and most common among those who provided more than five hours a week.

When caregiving ceased from one survey year to the following one, researchers saw a drop in reported sleep troubles.

Caregivers were more likely to be female and older, to have less education, to work less than 20 paid hours per week and to report physical pain, chronic illness, poor health and depression.

"This means that increases in informal caregiving that are expected in the years ahead as a result of population aging may hit those who are already struggling the hardest," Sacco said.

The study team saw no difference in sleep problems between men who provided no care versus those who provided up to five hours of caregiving, but women reported sleep problems at all levels of caregiving. That could be related to the different tasks that men and women perform as caregivers, the authors write in the journal Sleep.

Future studies should look at working people in various countries, Sacco added, since Sweden uses a welfare model aimed at minimizing conflict between paid work and caregiving commitments.

"This is a wake-up call to governments and employers that they should be supporting informal caregivers better," he said.

In addition, future research should examine what types and aspects of caregiving affect sleep the most, said Dr. Barry Oken of Oregon Health and Science University in Portland, who wasn't involved in the study.

"Caregiving at home for someone with dementia or chronic pain may cause more problems with the care recipient's sleep and perhaps then the caregiver's sleep," he told Reuters Health by email.

Oken said he is interested in finding ways to help caregivers improve their sleep. In recent studies, he and colleagues have found that mind-body practices, such as mindfulness meditation, can improve mental health in caregivers and stressed older adults.

"Be aware that sleeping may be impacted by caregiving and explore with health providers what you can do to minimise it," he said. "What society can do to help minimise this is alluded to here but is a bigger question."