"What Hath Night to Do with Sleep?": The Caregiving Context and Dementia Caregivers' Nighttime Awakenings.

OBJECTIVES: Care provision for persons with dementia can be rewarding yet may disrupt caregiver's sleep health. Using the National Health & Aging Trends Study and the National Study of Caregiving, we examine care receiver and caregiver contextual factors, caregiver health and psychological wellbeing as predictors of caregivers' nighttime awakenings.

METHODS: The sample for this cross-sectional study included 451 caregivers for individuals with dementia surveyed by telephone.

RESULTS: Nighttime awakenings (1 item measure of waking and not being able to return to sleep) almost every night were reported by 16% of caregivers and 10% reported that helping the care receiver caused their sleep to be interrupted most nights. In a multinomial logistic regression, caregivers' greater nighttime awakenings were associated with caring for care recipients with higher fall risk, as well as caregiver characteristics of more chronic medical conditions and emotional difficulty of the care role.

CONCLUSIONS: Emotional caregiving difficulties were associated with nighttime awakenings even accounting for caregivers' health and care receivers' disability. Thus, interventions improving caregiver distress may improve sleep health.

CLINICAL IMPLICATIONS: Clinicians should screen caregivers for nighttime awakenings so that evidence-based interventions and treatments can be implemented to prevent persistent sleep disturbances.