How does beginning or ceasing of informal caregiving of individuals in poor health influence sleep quality? Findings from a nationally representative longitudinal study

BACKGROUND: Various cross-sectional studies exist examining the association between informal caregiving and sleep quality. However, there is a lack of longitudinal studies investigating whether beginning and ceasing of informal caregiving is associated with changes in sleep quality.

AIMS: Investigating whether beginning and ceasing of informal caregiving of individuals in poor health is associated with changes in sleep quality in both sexes.

METHODS: Data were taken from a nationally representative sample of individuals ≥ 40 years in Germany from 2008 to 2017. In our analytical sample, n equaled 22,910 observations. Based on the Pittsburgh Sleep Quality Index, the sleep quality was assessed by the difficulties falling asleep during the last month, difficulties with sleep because of waking up during the last month (in both cases: (from 1 = not during the last month to 4 = three or more times a week) and the overall assessment of sleep quality during the last month (from 1 = very good to 4 = very bad).

RESULTS: Asymmetric fixed effects regressions showed that in men beginning to provide informal care was associated with decreased overall sleep quality (β=-.09 (95% CI: -.15 - -.03), p<.01) and an increased likelihood of difficulties because of waking up (OR: 1.54 (95% CI: 1.07-2.20), p<.05), whereas ceasing to provide informal care was not associated with the outcome measures (both, in women and in men).

DISCUSSION: Starting informal caregiving had deleterious effects on sleep quality in men.

CONCLUSIONS: Efforts to assist men in maintaining sleep quality may be beneficial.