Leggett Amanda N, Morley Madelyn, Smagula Stephen F
Department of Psychiatry, 4250 Plymouth Rd. University of Michigan, Ann Arbor, MI, USA, 734-232-0538.
School of Public Health, 1415 Washington Heights, University of Michigan, Ann Arbor, MI, USA 48109, 734-764-5425.
Curr Sleep Med Rep. 2020 Mar;6(1):1-10. doi: 10.1007/s40675-020-00164-0. Epub 2020 Feb 1.
This paper critically evaluates literature from the last three years on sleep in caregivers for older adults. Research is evaluated in four main areas: factors related to caregivers having sleep problems, sleep health in various types of caregivers, how caregivers' sleep and health inter-relate, and interventions to improve sleep.
A range of both care recipients' and caregivers' characteristics have been associated with caregiver sleep quality measured subjectively and objectively. Care recipient factors associated with caregiver sleep quality include fall risk and sleep quality, while caregiver factors include stress, duration, intensity, provision of medical/nursing care tasks, and even particular serotonin genotypes (e.g. short allele carriers for 5-HTTLPR). While the greatest focus has been on dementia caregivers, recent work suggests groups such as end-of-life caregivers, former caregivers, and caregivers with multiple care roles (e.g. child, older adult, paid care) have sleep disturbances that vary by their unique contexts. Caregiver's sleep, particularly subjective assessments, relates to their mood and physiological well-being; and evidence suggests that sleep may be an important mediator linking care stressors with mental health. Factors such as mindfulness and sense of coherence may protect caregivers from sleep disturbances.
本文对过去三年中关于老年人照料者睡眠的文献进行了批判性评估。研究主要从四个方面进行评估:与照料者睡眠问题相关的因素、各类照料者的睡眠健康状况、照料者的睡眠与健康之间的相互关系以及改善睡眠的干预措施。
一系列受照料者和照料者的特征都与通过主观和客观测量得出的照料者睡眠质量相关。与照料者睡眠质量相关的受照料者因素包括跌倒风险和睡眠质量,而照料者因素包括压力、时长、强度、医疗/护理任务的提供情况,甚至特定的血清素基因型(例如5-HTTLPR短等位基因携带者)。虽然最大的关注焦点一直是痴呆症照料者,但最近的研究表明,临终照料者、前照料者以及承担多种照料角色(如照顾儿童、老年人、付费护理对象)的照料者等群体存在因各自独特背景而异的睡眠障碍。照料者的睡眠,尤其是主观评估,与其情绪和生理健康相关;有证据表明,睡眠可能是将照料压力源与心理健康联系起来的重要调节因素。正念和连贯感等因素可能会保护照料者免受睡眠障碍的影响。