Barriers to and Facilitators of Sleep Health in Family Caregivers of Persons Living With Dementia: A Qualitative Study.

Abstract

Purpose: Sleep disturbances are common among family caregivers of persons living with dementia (PLWD), yet few interventions are designed to address these sleep challenges. Existing sleep interventions often overlook the specific barriers and facilitators that shape caregivers' sleep experiences. A clearer understanding of these factors is essential for developing tailored, acceptable, and effective interventions to support caregiver sleep health.

Method: The current secondary data analysis used a qualitative descriptive design. Nineteen family caregivers of PLWD who provided unpaid care for >4 hours per day and had insomnia symptoms (Insomnia Severity Index score >5) participated in the current study. Semi-structured interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis.

Results: Caregivers, on average, were aged 63 years (SD = 8.2 years), and primarily female (57.9%), White (68.4%), and spouses (78.9%). Themes for barriers to good sleep were: (1) Connectedness of the PLWD Behavior With Caregiver Sleep, (2) Caregiver Responsibilities and Worries, and (3) Pre-Existing Sleep Problems and Age-Related Health Conditions. Themes for facilitators of good sleep were: (1) Physical Activity and Mindfulness Practices, (2) Using Sleep Hygiene Strategies, and (3) Preferring Nonpharmacological Sleep Solutions Despite Medication Benefits.

Conclusion: The current study identified several modifiable barriers and facilitators that can inform future interventions. These findings underscore the need for early, proactive interventions that incorporate nonpharmacological strategies and consider the interconnected nature of sleep within the caregiving relationship.