Quach Ha-Linh, Lim-Soh Jeremy, Malhotra Rahul
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Sleep Med. 2025 Sep;133:106628. doi: 10.1016/j.sleep.2025.106628. Epub 2025 Jun 4.
The association of caregiving status with sleep quality, and the impact of psychological resilience on caregivers' sleep quality, is inconclusive. We assess (i) the difference in sleep quality between family caregivers of older adults with functional limitations and non-caregivers, (ii) moderation of the association between caregiving status and sleep quality by psychological resilience, and (iii) among caregivers, the association of psychological resilience with sleep quality.
Cross-sectional data on 180 family caregivers and 149 non-caregivers in Singapore was analyzed. Sleep quality and psychological resilience were measured using the Pittsburgh Sleep Quality Index (PSQI) and Connor-Davidson resilience scale respectively. The probability of being a caregiver, conditional on covariates, informed a propensity score, which was used for calculating inverse probability of treatment weights (IPTWs). Multivariable linear regression models assessed the association of caregiving status with sleep quality and its moderation by psychological resilience (adjusted for IPTWs), and the relationship of psychological resilience with caregivers' sleep quality. Sensitivity analysis entailed propensity score matching.
Caregivers, versus non-caregivers, had poorer PSQI scores (total; subjective sleep quality; and daytime dysfunction). However, this association was moderated by psychological resilience - the difference in sleep quality between caregivers and non-caregivers reduced with higher psychological resilience. Among caregivers, those with higher psychological resilience had more favorable PSQI scores (total; subjective sleep quality; sleep latency; sleep duration; sleep efficiency; and daytime dysfunction).
Being an informal caregiver has a detrimental effect on sleep quality. Higher psychological resilience may be associated with better sleep quality among informal caregivers.
照顾者状态与睡眠质量之间的关联，以及心理弹性对照顾者睡眠质量的影响尚无定论。我们评估：（i）有功能障碍的老年人的家庭照顾者与非照顾者之间睡眠质量的差异；（ii）心理弹性对照顾者状态与睡眠质量之间关联的调节作用；（iii）在照顾者中，心理弹性与睡眠质量之间的关联。
分析了新加坡180名家庭照顾者和149名非照顾者的横断面数据。分别使用匹兹堡睡眠质量指数（PSQI）和康纳-戴维森弹性量表测量睡眠质量和心理弹性。根据协变量得出成为照顾者的概率，据此得出倾向得分，用于计算治疗权重的逆概率（IPTWs）。多变量线性回归模型评估照顾者状态与睡眠质量之间的关联及其通过心理弹性的调节作用（对IPTWs进行校正），以及心理弹性与照顾者睡眠质量之间的关系。敏感性分析采用倾向得分匹配法。
与非照顾者相比，照顾者的PSQI得分更低（总分、主观睡眠质量和日间功能障碍方面）。然而，这种关联受到心理弹性的调节——照顾者与非照顾者之间的睡眠质量差异随着心理弹性的提高而减小。在照顾者中，心理弹性较高者的PSQI得分更优（总分、主观睡眠质量、睡眠潜伏期、睡眠时间、睡眠效率和日间功能障碍方面）。
作为非正式照顾者对睡眠质量有不利影响。较高的心理弹性可能与非正式照顾者更好的睡眠质量相关。
