Although research has linked sleep problems, anxiety, and poor health outcomes among patients’ family members in nonhospice settings, little is known about these often interrelated issues among hospice family caregivers.
Objectives:
We sought to examine the relationships between sleep problems, anxiety, and global self-rated health among hospice family caregivers.
Methods, Setting, and Patients:
We conducted a secondary analysis of quantitative data from 395 family caregivers of hospice patients in the Midwest and Southeastern United States.
Results:
Nearly one-third of the hospice family caregivers who participated in this study experienced clinically noteworthy levels of sleep problems and/or anxiety. Caregivers’ symptoms of anxiety and sleep problems were strongly correlated. Caregivers who reported more frequent sleep problems and higher levels of anxiety reported poorer overall health.
Conclusion:
Hospice providers, who are charged with attending to the needs of both patients and their family caregivers, may improve their practice by regularly assessing for sleep problems and anxiety among family caregivers and providing appropriate interventions or referrals.
HudsonP. Positive aspects and challenges associated with caring for a dying relative at home. Int J Palliat Nurs. 2004;10(2):58–65.
4.
Wittenberg-LylesEDemirisGParker OliverDWashingtonKBurtSShaunfieldS. Stress variances among informal hospice caregivers. Qual Health Res. 2012;22(8):1114–1125.
5.
Chentsova-DuttonYShucterSHutchinSStrauseLBurnsKZisookS. The psychological and physical health of hospice caregivers. Ann Clin Psychiatry. 2000;12(1):19–27.
6.
WashingtonKTDemirisGPikeKCKruseRLParker OliverD. Anxiety among informal hospice caregivers: an exploratory study. Palliat Support Care. 2015;13(3):567–573.
7.
KotronoulasGWengstromYKearneyN. Sleep patterns and sleep-impairing factors of persons providing informal care for people with cancer: a critical review of the literature. Cancer Nurs. 2013;36(1):E1–E15.
8.
LeeKCYiinJJLuSHChaoYF. The burden of caregiving and sleep disturbance among family caregivers of advanced cancer patients. Cancer Nurs. 2015;38(4):E10–E18.
9.
McCurrySMLogsdonRGTeriLVitielloMV. Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. Sleep Med Rev. 2007;11(2):143–153.
10.
RoweMAMcCraeCSCampbellJMBenitoAPChengJ. Sleep pattern differences between older adult dementia caregivers and older adult noncaregivers using objective and subjective measures. J Clin Sleep Med. 2008;4(4):362–369.
11.
AkerstedtTPerskiAKecklundG. Sleep, occupational stress, and burnout. In: KrygerMRothTDementWC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:736–741.
12.
MeltzerLJMindellJA. Impact of a child’s chronic illness on maternal sleep and daytime functioning. Arch Intern Med. 2006;166(16):1749–1755.
13.
HearsonBMcClementSMcMillanDEHarlosM. Sleeping with one eye open: the sleep experience of family members providing palliative care at home. J Palliat Care. 2011;27(2):69–78.
14.
JavaheriSDragerLFLorenzi-FilhoG. Sleep and cardiovascular disease: present and future. In: KrygerMRothTDementWC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:1222–1228.
15.
ParkJGRamarK. Sleep and chronic kidney disease. In: KrygerMRothTDementWC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:1323–1328.
16.
FarautBBoudjeltiaKZVanhammeLKerkhofsM. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev. 2012;16(2):137–149.
17.
McCurrySMSongYMartinJL. Sleep in caregivers: what we know and what we need to learn. Curr Opin Psychiatry. 2015;28(6):497–503.
18.
LerdalAGayCLSaghaugE. Sleep in family caregivers of patients admitted to hospice: a pilot study. Palliat Support Care. 2014;12(6):439–444.
19.
LerdalASlattenKSaghaugE. Sleep among bereaved caregivers of patients admitted to hospice: a 1-year longitudinal pilot study. BMJ Open. 2016;6(1):e009345.
20.
KruseRLParker OliverDWittenberg-LylesEDemirisG. Conducting the ACTIVE randomized trial in hospice care: keys to success. Clinical Trials. 2013;10(1):160–169.
21.
RatkowskiKLWashingtonKTCraigKWAlbrightDL. The stress of sadness: the most stressful symptoms for hospice family caregivers. American Journal of Hospice and Palliative Medicine. 2016;32(7):745–749.
22.
KroenkeKSpitzerRLWilliamsJB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613.
23.
SpitzerRLKroenkeKWilliamsJBLoweB. A brief measure for assessing Generalized Anxiety Disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097.
24.
DeSalvoKBBloserNReynoldsKHeJMuntnerP. Mortality prediction with a single general self-rated health question: a meta-analysis. J Gen Intern Med. 2006;21(3):267–275.
25.
DemirisGParker OliverDWittenberg-LylesE. A noninferiority trial of a problem-solving intervention for hospice caregivers: in person versus videophone. J Palliat Med. 2012;15(6):653–660.
26.
CarterPA. A brief behavioral sleep intervention for family caregivers of persons with cancer. Cancer Nurs. 2006;29(2):95–103.
27.
McCurrySMLogsdonRGVitielloMVTeriL. Successful behavioral treatment for reported sleep problems in elderly caregivers of dementia patients: a controlled study. J Gerontol B Psychol Sci Soc Sci. 1998;53(2):P122–129.
28.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
29.
MalowBA. Approach to the patient with disordered sleep. In: KrygerMRothTDementWC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:573–575.
30.
WangXRobinsonKMHardinHK. The impact of caregiving on caregivers’ medication adherence and appointment keeping. West J Nurs Res. 2015;37(12):1548–1562.
31.
KrygerMRothTDementWC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017.
32.
EpsteinLJKristoDStrolloPJJr. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263–276.
33.
QaseemAKansagaraDForcieaMACookeMDenbergTD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133.
34.
MirerAGYoungTPaltaMBencaRMRasmusonAPeppardPE. Sleep-disordered breathing and the menopausal transition among participants in the Sleep in Midlife Women Study. Menopause. 2017;24(2):157–162.
