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Health Services Research & Development

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2008 HSR&D National Meeting Abstract

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National Meeting 2008

3068 — Relationship Between Stroke Caregiver Sleep Patterns and Caregiver Burden, Health, and Depression

Hinojosa MS (University of Wisconsin - Milwaukee)

Objectives:
Poor sleep is a common problem for older adults and is associated with a variety of illnesses, increased healthcare costs, decreased positive affect, decreased vigor, and increased fatigue and morbidity. The effects of sleep fragmentation on caregivers of veterans post stroke have not been investigated. The purpose of this descriptive study is to explore the relationship between stroke caregivers’ subjective sleep experiences and caregiver burden, self rated health and depression.

Methods:
Data were obtained from 285 stroke caregivers of veterans following discharge home post stroke through telephone surveys. Subjective sleep experience includes: amount of sleep, sleep quality, falling asleep, nighttime waking, importance of sleep, daytime enthusiasm, and use of sleep medication. The CES-D 10 was used to assess depressive symtomology, self rated health was measured on a likert type scale and burden was measured by the number of ADLs and IADLs which caregivers provide ongoing assistance.

Results:
Analyses controlling for caregiver demographics reveal that increased depressive symptomology is related to less sleep at night (OR=2.92, 95% CI 1.35 – 6.29), difficulty achieving daytime enthusiasm (OR .102, 95% CI .046 - .224), poor sleep quality (OR .084, 95% CI .023 - .311), and use of sleep medication (OR .160, 95% CI .074 - .345). Poor health is related to less hours of sleep at night (OR 2.49, 95% CI 1.13 – 5.49), difficulty with daytime enthusiasm (OR .166, 95% CI .048 - .570), poor sleep quality (OR .091, 95% CI .024 - .349), and use of sleep medication (OR 6.25, 95% CI 2.90 – 12.45). Greater caregiver burden is associated with less hours of sleep (B=1.76, p=.040) and use of sleep medication (B=-2.15, p=.0081).

Implications:
Approximately 80% of stroke patients are discharged home to continue recovery with informal caregivers providing care around the clock. Findings indicate that caregiver sleep patterns are related to increased depression, burden, and poor health.

Impacts:
Little attention has been paid to addressing sleep problems of caregivers of stroke patients following discharge home. Findings indicate that interventions to promote sleep may be important to reduce caregiver depression and burden and improve the health of informal caregivers of veterans.


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