Predictors of Sleep Quality in Spouse Caregivers of Community-Dwelling People With Dementia Using Propensity Score Matching Analysis

Background: Many family caregivers of people with dementia (PwDs) have sleep problems and poor sleep quality. Sleep may be negatively affected by caring for a family member with dementia, especially a spouse. Purpose: This study was designed to assess sleep quality in spouse caregivers of PwDs and determine the impact of care provision on their sleep quality. Methods: A secondary analysis of 58,050 participants in the 2018 Korea Community Health Survey was conducted. To prevent selection bias, a propensity score matching analysis was performed. Multiple logistic regression analysis was conducted to investigate the predictors of sleep quality. Results: After obtaining a propensity score matching threshold of 3:1, the percentage of poor sleepers was 24.2% in the control group and 33.3% in the spouse-caregiver group, which indicates a significant difference (chi(2) = 11.79, p =.001). After adjusting for depressive symptoms in the multiple logistic analyses, no intergroup difference was found in terms of risk of poor sleep quality (odds ratio = 1.12, 95% CI [0.90, 1.61]). Conclusions/Implications for Practice: The findings of this study support that spouse caregivers of PwDs have poorer sleep quality than their nonspouse peers and that management of depressive symptoms is important to improving the sleep quality of spouses providing care to PwDs. Nursing interventions such as light therapy and exposure to sunlight during daytime hours to both improve sleep quality and reduce depressive symptoms can improve sleep quality in this vulnerable caregiver group.