Coping Resources and Sleep Health: Differences between Dementia and Non-Dementia Caregiving

Background and Purpose

Providing care for older adults with dementia is often characterized by high levels of physical demands and emotional stress, which can significantly disrupt caregivers’ sleep. Approximately 67% of U.S. caregivers of older adults with dementia report experiencing sleep problems. Growing research shows that coping resources, such as resilience and perceived gains from caregiving, can improve caregiver well-being. However, limited knowledge exists regarding how these coping resources influence sleep health, and research exploring potential differences in this relationship by caregiving status remains scarce. This study aims to examine whether the impact of coping resources on sleep health differs between dementia caregiving and non-dementia caregiving.

Methods

Data were drawn from the 2017 National Study of Caregiving, which included caregivers of Medicare enrollees aged 65 and older in the United States (N = 2652). Caregiving status was dichotomized as dementia caregiving and non-dementia caregiving. Coping resources included resilience and perceived gains from caregiving. Sleep outcomes included sleep satisfaction, sleep disturbance, difficulty falling asleep, and whether waking up at night. Caregiver age, gender, self-rated health, and co-residence status (i.e., whether caregiver lives with care recipient) were included as covariates. Multiple linear regression and logistic regression were used to examine the study aim.

Results

Caregiving status significantly moderated the association between resilience and sleep among caregivers (B = -.13, p < .01). For dementia caregivers, higher levels of resilience were associated with lower levels of difficulty falling asleep. For non-dementia caregivers, this effect was minimal. Additionally, the effect of perceived caregiving gains on sleep differed significantly by caregiving status (Logit = .47, p < .05). Among dementia caregivers, those who perceived greater gains from caregiving were more likely to wake up during the night. In contrast, non-dementia caregivers who perceived greater gains from caregiving were less likely to wake up during the night.

Conclusions and Implications

The findings of our study offer a nuanced understanding of the differences between dementia and non-dementia caregiving. Specifically, resilience protects against sleep problems among dementia caregivers, but not among their non-dementia counterparts. Interventions aimed at strengthening resilience can be an effective approach to mitigating sleep problems among dementia caregivers. While existing research identifies perceived caregiving gains as a valuable psychological resource, our study suggests they may also contribute to increased involvement and a heightened sense of responsibility, which can disrupt sleep among dementia caregivers. Therefore, psychosocial interventions should help dementia caregivers recognize the dual role of caregiving gains and reinforce that maintaining sleep health is essential for sustainable and effective caregiving. Future research should examine the mechanisms underlying the negative impact of caregiving gains on sleep among dementia caregivers and conduct in-depth interviews to explore the meaning of gains from caregiving in this population.