Abstract
Family caregivers are at high risk of psychological distress and low sleep efficiency resulting from their caregiving responsibilities. Although psychological symptoms are associated with sleep efficiency, there is limited knowledge about the association of psychological distress with variations in sleep efficiency. We aimed to characterize the short- and long-term patterns of caregivers’ sleep efficiency using Markov chain models and compare these patterns between groups with high and low psychological symptoms (i.e., depression, anxiety, and caregiving stress). Based on 7-day actigraphy data from 33 caregivers, we categorized sleep efficiency into three states, < 75% (S1), 75–84% (S2), and ≥ 85% (S3), and developed Markov chain models. Caregivers were likely to maintain a consistent sleep efficiency state from one night to the next without returning efficiently to a normal state. On average, it took 3.6–5.1 days to return to a night of normal sleep efficiency (S3) from lower states, and the long-term probability of achieving normal sleep was 42%. We observed lower probabilities of transitioning to or remaining in a normal sleep efficiency state (S3) in the high depression and anxiety groups compared to the low symptom groups. The differences in the time required to return to a normal state were inconsistent by symptom levels. The long-term probability of achieving normal sleep efficiency was significantly lower for caregivers with high depression and anxiety compared to the low symptom groups. Caregivers’ sleep efficiency appears to remain relatively consistent over time and does not show rapid recovery. Caregivers with higher levels of depression and anxiety may be more vulnerable to sustained suboptimal sleep efficiency.
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The data that support the findings of this study are available from the corresponding author upon reasonable request.
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This research was supported by the Council for the Advancement of Nursing Science/Southern Nursing Research Society (CANS/SNRS) Dissertation Research Grant.
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All authors contributed to the study conception and design. Material preparation and data collection were performed by SA and JGL and data analysis and interpretation were conducted by SA, JML, and JGL. The first draft of the manuscript was written by SA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Ahn, S., Lobo, J.M., Davis, E.M. et al. Characterization of sleep efficiency transitions in family caregivers. J Behav Med 47, 308–319 (2024). https://doi.org/10.1007/s10865-023-00461-3
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DOI: https://doi.org/10.1007/s10865-023-00461-3