Better understanding of and advocating for caregivers’ needs is at the heart of much of Dr. Marcela Blinka’s research at COAH. Recently, she and her colleagues considered that caregiving can be a source of stress, depression and anxiety, and that these factors can affect sleep quality. So how does caregiving impact sleep quality? How much? What does that mean to the health of caregivers?
Seeking answers to these questions, Dr. Blinka and a team of COAH researchers examined data from the Caregiving Transitions Study (CTS), a highly-respected national population-based caregiver study. Joining Dr. Blinka, the COAH team consisted of Drs. Adam Spira, Orla Sheehan, and David L. Roth, and Tom Cidav, along with Dr. Virginia Howard and J. David Rhodes from the University of Alabama at Birmingham. The CTS looks at how the caregiver role impacts the health of those who have recently become caregivers among participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. REGARDS is a national population-based sample study of adults over age 45 in the US, looking at causal factors for the high stroke rate and death differences between Black and White residents of the Southern “Stroke Belt.”
Dr. Blinka and the research team delved into CTS data to examine the self-reported sleep characteristics of incident caregivers (CTS study participants that became caregivers after enrollment) and non-caregiving controls. The controls were matched based on age, sex, race, education, marital status, history of cardiovascular disease, and self-rated health factors; controls did not have extended family caregiving responsibilities during their participation in the study. The study examined the relationship between caregiving and multiple self-report measures of sleep duration and quality, as well as a number of additional factors. Blinka et al.’s findings are discussed in “Sleep Quality Reports from Family Caregivers and Matched Non-Caregiving Controls in a Population-Based Study,” which is published online ahead of print in the Journal of Applied Gerontology, March 26, 2022 and available here.
The implications of their study’s results are particularly meaningful because their data may apply to caregivers throughout the country. In 2020, the AARP and the National Alliance for Caregiving survey estimated that more than 50 million Americans provide unpaid care for adult family members or friends; projections of the number of Americans who are 80 years or older is expected to rise from about 13 million in 2015 to about 35 million in 2050. Anticipating their well-being is critically important to the future of our society.
Here’s what they discovered:
- Caregivers reported significantly longer sleep onset latency than controls, before and after adjusting for covariates (ps < 0.05).
- No differences were found on measures of total sleep time or sleep efficiency.
- Among caregivers only, employed persons reported less total sleep time, and the number of care hours was a significant predictor of total sleep time.
- Dementia caregivers did not differ from other caregivers.
Of noteworthy importance, however, Blinka’s team observed that poor sleep quality increases the risk for future physical and mental impairments—and with a vastly expanding number of caregivers projected in the future, this could become a health crisis if left unchecked: “Effective interventions to assess and improve caregivers’ sleep quality are needed.”
Wondering if you’re getting enough sleep? Experts recommend 6 to 8 hours of sleep for optimal health, in general. And if you’re having trouble getting restful sleep, please make an appointment and discuss the matter with your doctor.
Dr. Blinka underscores the importance of the general research consensus on the cumulative effects of sleep deprivation over time; sleeping in on weekends doesn’t make up for it—“You can’t get it back.” Dr. Blinka urges caregivers to be proactive in minding their sleep hygiene as a critical component of well-being and self-care.
Declaration of Conflict of Interest: Dr. Spira received an honorarium as a consultant to Merck and honoraria from Springer Nature Switzerland AG for guest editing special issues of Current Sleep Medicine Reports.
By Anthony L. Teano, MLA
Communications Specialist
As a pre-schooler, I declared that I wanted to be “mommy and daddy’s doctor” and followed through! I was always drawn to a medical career, a career centered around caring for others. I made the commitment to medicine early, going to a joint BA/MD program for undergrad and medical school (Lehigh University and Drexel University in PA). During my internal medicine residency at Yale, I was drawn to geriatrics because I loved the emphasis on the whole person and family as well as the “less can be more” approach. I think I was subconsciously also led to geriatrics by my dad’s dementia diagnosis. I never envisioned a research career, but I got involved in my first research project related to advance care planning with Terri Fried at Yale. That first experience peeked my interest in research, and I came to Johns Hopkins for a clinical and research fellowship in geriatrics to 
get more training in aging research and see if I would enjoy research long-term (Hopkins was also closer to my parents, which was important to me). As a fellow, COAH Director Dr. David L. Roth was one of the first mentors I connected with. His mentorship helped me obtain my earliest grants using National Health and Aging Trends Study (NHATS) data to examine potentially unsafe activities among older adults with dementia and then extending that work to examine people living with undiagnosed dementia with NHATS-linked Medicare claims data. Many of my mentors are core or associate faculty of COAH, and I love the interdisciplinary connections and collaborations it brings.
As I carved out a career as a clinician investigator, I focused on dementia care and health services for people living with dementia due to my dad’s diagnosis. He was diagnosed with early-onset frontotemporal dementia just as I was graduating from medical school. Through our family’s experiences, and now also through experiences of my Memory Clinic patients, I have seen the many ways in which medical care and our health care systems fail people with dementia, from diagnosis until death. I know that there are policies, interventions, and clinical practice changes that can improve the care and support that individuals and families receive. My work, and the work of many others, is trying to bring those needed changes. Research can also be daunting when you see the work of senior or established researchers; because of my personal experience, I felt dementia care was one area where I had expertise even as an early career investigator.
Tom Cidav – New hire: Biostatistician (April 2020)
