Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA.
School of Nursing, University of California Los Angeles, California, Los Angeles, USA.
J Gerontol B Psychol Sci Soc Sci. 2023 Mar 13;78(Suppl 1):S38-S47. doi: 10.1093/geronb/gbac096.
Poor sleep is common among older adults with chronic health conditions and their spousal caregivers. However, dyadic sleep patterns among spouses are underexplored within the literature. This study examines dyadic sleep characteristics and associated contextual factors among spousal care dyads.
Participants included 462 older adult spousal care dyads from the 2015 National Health and Aging Trends Study and National Study of Caregiving (mean ages of care recipients/caregivers = 79 and 76 years, respectively; 22% of dyads were living with dementia). Self-reported sleep included frequency of (a) trouble falling back asleep among dyads, (b) care-related sleep disturbances among caregivers, and (c) trouble initiating sleep among care recipients. Predictors included between-dyad characteristics such as whether respondents had dementia, care burden and support, relationship quality, neighborhood cohesion, and within-dyad characteristics such as demographics, depression, and positive affect. We conducted multilevel dyadic analysis and actor-partner interdependence modeling.
Sleep was correlated more among dyads living with dementia than those with other chronic conditions. Care dyads had poorer sleep if caregivers reported higher care burden; however, better relationship quality marginally ameliorated the association. Depressive symptoms had a partner effect on poorer sleep among care dyads, whereas positive emotions and older age only had an actor effect on better sleep for care recipients and spousal caregivers. Neighborhood cohesion, care support, and other demographic characteristics were not associated with dyadic sleep outcomes.
Addressing both care recipient- and caregiver-related factors may improve sleep health for both members of the care dyad living with chronic conditions.
慢性健康状况的老年患者及其配偶照顾者普遍存在睡眠质量差的问题。然而，配偶之间的睡眠模式在文献中研究较少。本研究调查了配偶照顾者对睡眠的特征及其相关的环境因素。
参与者包括来自 2015 年国家健康老龄化趋势研究和国家护理研究的 462 对老年配偶照顾者（被照顾者/照顾者的平均年龄分别为 79 岁和 76 岁，22%的夫妇生活在痴呆症中）。自我报告的睡眠包括（a）夫妇中睡眠困难的频率，（b）照顾者中与照顾相关的睡眠障碍，以及（c）照顾对象中睡眠困难的频率。预测因素包括：受访者是否患有痴呆症、照顾负担和支持、关系质量、邻里凝聚力等，以及人口统计学、抑郁和积极情绪等。我们进行了多层次的对偶分析和行为者-伙伴相互依存模型。
与其他慢性疾病相比，生活在痴呆症中的夫妇睡眠更相关。如果照顾者报告的照顾负担较高，那么照顾者的睡眠质量较差；但是，较好的关系质量略微改善了这种关联。抑郁症状对照顾者的睡眠有伴侣效应，而积极情绪和年龄较大对照顾对象和配偶照顾者的睡眠有积极影响。邻里凝聚力、照顾支持和其他人口统计学特征与对偶睡眠结果无关。
同时解决照顾对象和照顾者相关的因素可能会改善患有慢性疾病的照顾者对双方的睡眠健康。
