Taking care of a loved one can take a toll, but when it comes to sleep deprivation that toll can be invisible.
Baylor University sleep researchers found caregivers for dementia patients typically lose sleep but that simple strategies can help them get the rest they need, according to a recently published analysis. Doctoral candidate and lead author Chenlu Gao and Sleep Neuroscience and Cognition Laboratory Director Michael Scullin analyzed 35 studies on the impact of dementia on the patients’ caregivers and found they typically lose between 2.5 and 3.5 hours of sleep a week.
“Our lab has always been interested in understanding the consequences of dementia,” Gao said. “We want to help dementia patients, and through that we realized that dementia not only affects the patients, but affects the people around the patients.”
Scullin said existing research on the topic was scattered, and he hopes the new study will encourage discussion of sleep in caregiver groups and more broadly. He said the experiences of the more than 3,000 individuals in the studies they analyzed tend to follow a handful of themes.
“They have difficulty falling asleep because they’ve got a ton on their mind,” Scullin said. “They’ve got a ton to do every day, and it’s tough to turn off their mind. They’re not just worried about the things they’ve got to get done. They’re worrying about the physical and mental health and well-being of someone who they love.”
Interrupted sleep because of stress, preoccupation or being woken up to care for their loved ones also contribute to sleep loss, leaving them drained during the day and leading to a cycle of sleep deprivation.
Gao said with sleep deprivation comes impacts on mental and physical health as well as cognitive ability, particularly memory, which could result in missed doctor’s appointments, skipped medications or other errors. Missing sleep also opens caregivers to developing depression, she said.
“We know that if people are not sleeping well, they may have trouble regulating their mood, especially for caregivers, because they’re going through a lot of stress” Gao said.
Effects over time
Scullin said not everyone who experiences sleep deprivation will experience those effects, but the probability increases. Sleep loss has ubtle, cumulative, insidious effects over time, he said.
“We tell ourselves we’ve recovered after a night of good sleep, but we’re normally overestimating that,” Scullin said. “So, if you’re thinking of cutting back just 20 or 30 minutes a night, it’s not a big deal on that specific night, but if you go all week, now you’re more emotionally reactive, you have less vigilance, you’re sleepier, but the kicker is you might not realize why.”
The new study concludes that while caring for a loved one with dementia is stressful and demanding by nature, simple steps or “low-cost behavioral interventions,” can improve sleep quality.
“What we found from those studies we reviewed is that behavioral interventions are most effective,” Gao said. “Those are really simple behavioral strategies that caregivers can use.”
She said getting sunlight in the morning and exercising help people sleep more soundly, as does a consistent sleep schedule.
“People don’t realize that getting morning sunlight is really important to setting circadian rhythms throughout the day,” Scullin said. “It allows you to feel alert at the times you should feel alert and sleepy at the times you should feel sleepy.”
Sunny side up
He said sunlight in the morning is also a standard treatment for a dementia patient who is not sleeping well.
“Waco is terribly hot this time of year, but you find ways to make it work,” Scullin said.
The study was inspired in part by a meeting with the local Alzheimer’s Association chapter, he said.
“A few years ago when our lab was opening we reached out to them, because we have studied sleep and Alzheimer’s, sleep and aging, for a number of years,” Scullin said. “They really took to the idea that not just the patients, but the caregivers, have difficulty sleeping.”
He and Gao followed up by visiting with support groups and giving presentations about sleep deprivation. Scullin said they received a telling response from group members, and later led discussions on sleep at the association’s annual caregiver seminar.
“We decided a more systematic approach was needed,” Scullin said. “Not enough people we’re recognizing that sleep health was an issue among caregivers.”