Dementia behavioural and psychiatric symptoms: effect on caregiver's sleep

Authors

  • Cherie Simpson PhD, RN, CNS,

    Assistant Professor, Corresponding author
    1. School of Nursing, University of Texas at Austin, Austin, USA
    • Correspondence: Cherie Simpson, Assistant Professor, University of Texas at Austin, School of Nursing, 1700 Red River, Austin, TX 78701, USA. Telephone: +1 512 471 7944.

      E-mail: csimpson@mail.nur.utexas.edu

    Search for more papers by this author
  • Patricia Carter PhD, RN, CNS

    Associate Professor
    1. School of Nursing, University of Texas at Austin, Austin, USA
    Search for more papers by this author

Abstract

Aims and objectives

To examine caregiver sleep quality, especially in relation to the daytime and night-time behaviours and psychological symptoms exhibited by persons with dementias.

Background

Caregivers of persons with dementias experience poorer sleep in comparison with noncaregivers, and poor sleep is related to negative health outcomes. The reasons for caregivers' poor sleep are complex, and it is known that the night-time behaviours of the persons with dementia contribute to caregiver sleep disruption. However, the frequency of behavioural and psychological symptoms of dementia has hitherto not been sufficiently explored as a contributing factor to poor caregiver sleep.

Design

A nonexperimental cross-sectional design.

Methods

Eighty caregivers completed questionnaires on the frequency of behavioural and psychological symptoms of the persons with dementia, the Dementia Severity Rating Scale, the Pittsburgh Sleep Quality Index and the Center for Epidemiologic Studies Depression Scale.

Results

Poor sleep was reported with awakenings by the persons with dementia occurring for more than half of the caregivers. The frequency of behaviours and symptoms did not make a unique contribution to the variance of caregivers' global sleep. The frequency of behaviours, and specifically of agitation and apathy, contributed to the variance in subjective sleep quality, as defined by the caregivers' appraisal of their sleep.

Conclusions

The findings demonstrate the relationship between (1) daytime and night-time behaviours of persons with dementias and (2) their caregivers' sleep quality and emphasise the complexity of the factors that contribute to caregiver sleep quality.

Relevance to clinical practice

These findings suggest that nurses should be cognizant of the relationship between daytime behaviours of the persons with dementia and the caregivers' appraisal of their sleep, realising that appraising one's sleep as poor can be a contributing factor to perpetuating sleep problems. Interventions aimed at helping the caregiver manage the persons with dementia's agitation or the caregiver's emotional response to persons with dementia apathy may improve caregivers' perception of their sleep.

Ancillary