Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T03:26:55.989Z Has data issue: false hasContentIssue false
  • English
  • Français

Sleep disturbances in caregivers of patients with advanced cancer: A systematic review.

Published online by Cambridge University Press:  18 January 2017

Kirstin F. Maltby Open the ORCID record for Kirstin F. Maltby [Opens in a new window] ,
Christine R. Sanderson ,
Elizabeth A. Lobb  and
Jane L. Phillips
Kirstin F. Maltby*
Affiliation:
School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia Calvary Health Care Sydney, Kogarah, New South Wales, Australia
Christine R. Sanderson
Affiliation:
School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia Calvary Health Care Sydney, Kogarah, New South Wales, Australia CareSearch Palliative Care Knowledge Network, Department of Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia
Elizabeth A. Lobb
Affiliation:
School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia Calvary Health Care Sydney, Kogarah, New South Wales, Australia Cunningham Centre for Palliative Care, Darlinghurst, New South Wales, Australia
Jane L. Phillips
Affiliation:
The Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia
*
Address correspondence and reprint requests to: Kirstin Maltby, School of Medicine, The University of Notre Dame–Australia, 160 Oxford Street, Darlinghurst, New South Wales, 2010 Australia. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Sleep disturbances are a common issue for those who provide informal care to someone with a life-limiting condition. The negative consequences of poor sleep are well documented. The purpose of the present study was to determine the sleep patterns of caregivers of patients with advanced cancer.

Method:

An extensive systematic review of studies reporting empirical sleep data was undertaken in 2015 in accordance with the PRISMA Statement. A total of eight electronic databases were searched, with no date restrictions imposed. Additionally, a search of the bibliographies of the studies identified during the electronic search was conducted. Search terms included: “sleep,” “insomnia,” “sleep disturbance,” “circadian rhythm,” “caregiver,” “carer,” “advanced cancer,” “palliative cancer,” and MESH suggestions. The inclusion criteria required studies to be in English and to report primary qualitative and/or quantitative research that examined sleep in caregivers of patients with advanced cancer. Unpublished studies, conference papers, and dissertations were excluded.

Results:

Overall, 10 studies met the inclusion criteria and were included in the review. Two major findings emerged from the data synthesis. First, at least 72% of caregivers reported moderate to severe sleep disturbance as measured by the Pittsburgh Sleep Quality Index. Second, objective measurement of caregivers' sleep identified that some caregivers experienced up to a 44% reduction in their total sleep time compared to the recommended eight hours.

Significance of Results:

Reduction in total sleep time appears to be the biggest issue facing caregivers' sleep. Future studies need to explore the specific factors that cause these sleep disturbances and thus help to identify interventions to optimize sleep.

Keywords

SleepCaregiversAdvanced cancerReviewPalliative care
Type
Review Article
Information
Palliative & Supportive Care , Volume 15 , Issue 1 , February 2017 , pp. 125 - 140
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alhola, P. & Polo-Kantola, P. (2007). Sleep deprivation: Impact on cognitive performance. Neuropsychiatric Disease and Treatment, 3(5), 553–567. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656292/pdf/NDT-3-553.pdf.Google Scholar
Argyriou, A.A., Karanasios, P., Assimakopoulos, K., et al. (2011). Assessing the quality of sleep in Greek primary caregivers of patients with secondary progressive multiple sclerosis: A cross-sectional study. Journal of Pain and Symptom Management, 42(4), 541–547. Epub ahead of print Mar 27. Available from http://www.jpsmjournal.com/article/S0885-3924(11)00074-1/pdf.Google Scholar
Aslan, O., Sanisoglu, Y., Akyol, M., et al. (2009). Quality of sleep in Turkish family caregivers of cancer patients. Cancer Nursing, 32(5), 370–377.Google Scholar
Banks, S. & Dinges, D.F. (2007). Behavioral and physiological consequences of sleep restriction. Journal of Clinical Sleep Medicine, 3(5), 519–528. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978335/pdf/jcsm.3.5.519.pdf.Google Scholar
Berger, A.M., VonEssen, S., Kuhn, B.R., et al. (2003). Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: Results of a feasibility intervention study. Oncology Nursing Forum, 30(3), 513–522.Google Scholar
Berger, A.M., Parker, K.P., Young-McCaughan, S., et al. (2005). Sleep–wake disturbances in people with cancer and their caregivers: State of the science. Oncology Nursing Forum, 32(Suppl. 6), E98–E126.Google Scholar
Bermudez, E.A., Rifai, N., Buring, J., et al. (2002). Interrelationships among circulating interleukin-6, C-reactive protein, and traditional cardiovascular risk factors in women. Arteriosclerosis, Thrombosis, and Vascular Biology, 22(10), 1668–1673. Available from http://atvb.ahajournals.org/content/22/10/1668.long.Google Scholar
Bramwell, L., MacKenzie, J., Laschinger, H., et al. (1995). Need for overnight respite for primary caregivers of hospice clients. Cancer Nursing, 18(5), 337–343.CrossRefGoogle ScholarPubMed
Buysse, D.J., Reynolds, C.F., Monk, T.H., et al. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.CrossRefGoogle ScholarPubMed
Cappuccio, F.P., D'Elia, L., Strazzullo, P., et al. (2010 a). Quantity and quality of sleep and incidence of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 33(2), 414–420. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809295/pdf/zdc414.pdf.Google Scholar
Cappuccio, F.P., D'Elia, L., Strazzullo, P., et al. (2010 b). Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies. Sleep, 33(5), 585–392. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864873/pdf/aasm.33.5.585.pdf.Google Scholar
Carney, S., Koetters, T., Cho, M., et al. (2011). Differences in sleep disturbance parameters between oncology outpatients and their family caregivers. Journal of Clinical Oncology, 29(8), 1001–1006. Epub ahead of print Jan 31. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068050/pdf/zlj1001.pdf.CrossRefGoogle ScholarPubMed
Carter, P.A. (2002). Caregivers' descriptions of sleep changes and depressive symptoms. Oncology Nursing Forum, 29(9), 1277–1283.CrossRefGoogle ScholarPubMed
Carter, P.A. (2003). Family caregivers' sleep loss and depression over time. Cancer Nursing, 26(4), 253–259.Google Scholar
Carter, P.A. (2005). Bereaved caregivers' descriptions of sleep: Impact on daily life and the bereavement process. Oncology Nursing Forum, 32(4), 741.CrossRefGoogle ScholarPubMed
Carter, P.A. (2006). A brief behavioral sleep intervention for family caregivers of persons with cancer. Cancer Nursing, 29(2), 95–103.Google Scholar
Carter, P.A. & Acton, G. (2006). Personality and coping: Predictors of depression and sleep problems among caregivers of individuals who have cancer. Journal of Gerontological Nursing, 32(2), 45–53.Google Scholar
Carter, P.A. & Chang, B. (2000). Sleep and depression in cancer caregivers. Cancer Nursing, 23(6), 410–415.Google Scholar
Carter, P.A., Mikan, S.Q. & Simpson, C. (2009). A feasibility study of a two-session home-based cognitive behavioral therapy-insomnia intervention for bereaved family caregivers. Palliative & Supportive Care, 7(2), 197–206.Google Scholar
Castro, C.M., Lee, K.A., Bliwise, D.L., et al. (2009). Sleep patterns and sleep-related factors between caregiving and non-caregiving women. Behavioral Sleep Medicine, 7(3), 164–79.CrossRefGoogle ScholarPubMed
Chiu, Y.C., Lee, Y.N., Wang, P.C., et al. (2014). Family caregivers' sleep disturbance and its associations with multilevel stressors when caring for patients with dementia. Aging & Mental Health, 18(1), 92–101. Epub ahead of print Sep 20, 2013.Google Scholar
Cora, A.M.S., Partinico, M.M.S., Munafo, M.P., et al. (2012). Health risk factors in caregivers of terminal cancer patients: A pilot study. Cancer Nursing, 35(1), 38–47.CrossRefGoogle ScholarPubMed
Creese, J., Bédard, M., Brazil, K., et al. (2008). Sleep disturbances in spousal caregivers of individuals with Alzheimer's disease. International Psychogeriatrics, 20(1), 149–161. Epub ahead of print Apr 30, 2007.Google Scholar
de Souza, L., Benedito-Silva, A.A., Pires, M.L., et al. (2003). Further validation of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 26, 81–85.Google Scholar
Delgado-Guay, M., Parsons, H., Hui, D., et al. (2013). Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. The American Journal of Hospice & Palliative Care, 30(5), 455–461. Epub ahead of print Sep 4, 2012.Google Scholar
Ferrie, J.E., Shipley, M.J., Cappuccio, F.P., et al. (2007). A prospective study of change in sleep duration: Associations with mortality in the Whitehall II Cohort. Sleep, 30(12), 1659–1666. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276139/pdf/aasm.30.12.1659.pdf.Google Scholar
Flaskerud, J.H., Carter, P.A. & Lee, P. (2000). Distressing emotions in female caregivers of people with AIDS, age-related dementias, and advanced-stage cancers. Perspectives in Psychiatric Care, 36(4), 121–130.Google Scholar
Fonareva, I., Amen, A.M., Zajdel, D.P., et al. (2011). Assessing sleep architecture in dementia caregivers at home using an ambulatory polysomnographic system. Journal of Geriatric Psychiatry and Neurology, 24(1), 50–59. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342770/pdf/nihms371227.pdf,Google Scholar
Gibbins, J., McCoubrie, R., Kendrick, A.H., et al. (2009). Sleep–wake disturbances in patients with advanced cancer and their family carers. Journal of Pain and Symptom Management, 38(6), 860–870. Available from http://www.jpsmjournal.com/article/S0885-3924(09)00709-X/pdf.Google Scholar
Grandner, M.A., Patel, N.P., Gehrman, P.R., et al. (2010). Problems associated with short sleep: Bridging the gap between laboratory and epidemiological studies. Sleep Medicine Reviews, 14(4), 239–247. Epub ahead of print Nov 6, 2009. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888649/pdf/nihms144089.pdf.Google Scholar
Happe, S. & Berger, K. (2002). The association between caregiver burden and sleep disturbances in partners of patients with Parkinson's disease. Age and Ageing, 31(5), 349–354. Available from http://ageing.oxfordjournals.org/content/31/5/349.long.CrossRefGoogle ScholarPubMed
Harding, R., Epiphaniou, E., Hamilton, D., et al. (2012). What are the perceived needs and challenges of informal caregivers in home cancer palliative care? Qualitative data to construct a feasible psycho-educational intervention. Supportive Care in Cancer, 20(9), 1975–1982. Epub ahead of print Nov 10, 2011.Google Scholar
Harrison, Y. & Horne, J.A. (2000). The impact of sleep deprivation on decision making: A review. Journal of Experimental Psychology. Applied, 6(3), 236–249. Available from http://postcog.ucd.ie/files/Hrrison%20and%20horne.pdf.CrossRefGoogle ScholarPubMed
Hawker, S., Payne, S., Kerr, C., et al. (2002). Appraising the evidence: Reviewing disparate data systematically. Qualitative Health Research, 12(9), 1284–1299.Google Scholar
Hearson, B., McClement, S., McMillan, D.E., et al. (2011). Sleeping with one eye open: The sleep experience of family members providing palliative care at home. Journal of Palliative Care, 27(2), 69–78.Google Scholar
Heslop, P., Smith, G.D., Metcalfe, C., et al. (2002). Sleep duration and mortality: The effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women. Sleep Medicine, 3(4), 305–314.Google Scholar
Johns, M.W. (1991). A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep, 14(6), 540–545. Available from http://epworthsleepinessscale.com/wp-content/uploads/2016/06/a_new_method_for_measure_daytime_sleepiness_the_epworth_sleepiness_scale1.pdf,CrossRefGoogle ScholarPubMed
Johns, M.W. (1992). Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep, 15(4), 376–381. Available from http://www.mwjohns.com/wp-content/uploads/2009/murray_papers/reliabiltiy_and_factor_analysis_of_the_epworth_sleepiness_scale.pdf.Google Scholar
Kochar, J., Fredman, L., Stone, K.L., et al. (2007). Sleep problems in elderly women caregivers depend on the level of depressive symptoms: Results of the Caregiver–Study of Osteoporotic Fractures. Journal of the American Geriatrics Society, 55(12), 2003–2009. Epub ahead of print Oct 18.Google Scholar
Kojima, M., Wakai, K., Kawamura, T., et al. (2000). Sleep patterns and total mortality: A 12-year follow-up study in Japan. Journal of Epidemiology, 10(2), 87–93. Available from https://www.jstage.jst.go.jp/article/jea1991/10/2/10_2_87/_pdf.Google Scholar
Kotronoulas, G., Wengstrom, Y. & Kearney, N. (2013). Sleep patterns and sleep-impairing factors of persons providing informal care for people with cancer: A critical review of the literature. Cancer Nursing, 36(1), E1–E15.Google Scholar
Kripke, D.F., Garfinkel, L., Wingard, D.L., et al. (2002). Mortality associated with sleep duration and insomnia. Archives of General Psychiatry, 59(2), 131–136.Google Scholar
Lee, K., Yiin, J., Lu, S., et al. (2014). The burden of caregiving and sleep disturbance among family caregivers of advanced cancer patients. Cancer Nursing, 38(4), E10–E19.Google Scholar
Lee, K., Yiin, J., Lin, P., et al. (2015). Sleep disturbances and related factors among family caregivers of patients with advanced cancer. Psycho-Oncology, 24(12), 1632–1638. Epub ahead of print Apr 14.Google Scholar
Lichstein, K.L., Stone, K.C., Donaldson, J., et al. (2006). Actigraphy validation with insomnia. Sleep, 29(2), 232–239. Available from http://www.journalsleep.org/Articles/290214.pdf.Google ScholarPubMed
McCurry, S.M., Vitiello, M.V., Gibbons, L.E., et al. (2006). Factors associated with caregiver reports of sleep disturbances in persons with dementia. The American Journal of Geriatric Psychiatry, 14(2), 112–120. Available from http://faculty.washington.edu/vitiello/Recent%20Publications/065%20%20Factors%20associated%20with%20caregiver%20reports.pdf.pdf.Google Scholar
McCurry, S.M., Logsdon, R.G., Teri, L., et al. (2007). Sleep disturbances in caregivers of persons with dementia: Contributing factors and treatment implications. Sleep Medicine Reviews, 11(2), 143–153. Epub ahead of print Feb 6. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861844/pdf/nihms20118.pdf.Google Scholar
McCurry, S.M., Gibbons, L.E., Logsdon, R.G., et al. (2009). Insomnia in caregivers of persons with dementia: Who is at risk and what can be done about it? Sleep Medicine Clinics, 4(4), 519–526. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799891/pdf/nihms-116341.pdf.Google Scholar
McEwen, B.S. (2006). Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load. Metabolism, 55(10 Suppl. 2), S20–S23.Google Scholar
McKibbin, C.L., Ancoli-Israel, S., Dimsdale, J., et al. (2005). Sleep in spousal caregivers of people with Alzheimer's disease. Sleep, 28(10), 1245–1250. Available from http://www.journalsleep.org/Articles/281012.pdf.CrossRefGoogle ScholarPubMed
Monk, T.H., Germain, A. & Reynolds, C.F. (2010). Sleep disturbances in bereavement. Psychiatric Annals, 38(10), 671–675. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826218/pdf/nihms166541.pdf.Google Scholar
National Sleep Foundation (2015). National Sleep Foundation recommends new sleep durations. Washington, DC: National Sleep Foundation. Available from https://sleepfoundation.org/media-center/press-release/national-sleep-foundation-recommends-new-sleep-times.Google Scholar
Ohayon, M.M., Carskadon, M.A., Guilleminault, C., et al. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep, 27(7), 1255–1273. Available from http://www.ihfglobal.com/education_documents/REMSleep.pdf.CrossRefGoogle ScholarPubMed
Parthasarathy, S., Vasquez, M.M., Halonen, M., et al. (2014). Persistent insomnia is associated with mortality risk. The American Journal of Medicine, 128(3), 268–275. Epub ahead of print Oct 16. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340773/pdf/nihms-635632.pdf,Google Scholar
Pollak, C.P. & Perlick, D. (1991). Sleep problems and institutionalization of the elderly. Journal of Geriatric Psychiatry and Neurology, 4(4), 204–210.Google Scholar
Ratcliff, R. & van Dongen, H.P.A. (2009). Sleep deprivation affects multiple distinct cognitive processes. Psychonomic Bulletin & Review, 16(4), 742–751. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797337/pdf/nihms155296.pdf.Google Scholar
Rittman, M., Hinojosa, M.S. & Findley, K. (2009). Subjective sleep, burden, depression, and general health among caregivers of veterans poststroke. The Journal of Neuroscience Nursing, 41(1), 39–52.Google Scholar
Rowe, M.A., McCrae, C.S., Campbell, J.M., et al. (2008). Sleep pattern differences between older adult dementia caregivers and older adult noncaregivers using objective and subjective measures. Journal of Clinical Sleep Medicine. 4(4), 362–369. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542494/pdf/jcsm.4.4.362.pdf.Google Scholar
Spiegel, K., Leproult, R. & van Cauter, E. (1999). Impact of sleep debt on metabolic and endocrine function. Lancet, 354(0188), 1435–1439.Google Scholar
Stenberg, U., Ruland, C.M. & Miaskowski, C. (2010). Review of the literature on the effects of caring for a patient with cancer. Psycho-Oncology, 19(10), 1013–1025.Google Scholar
von Känel, R., Dimsdale, J.E., Ancoli-Israel, S., et al. (2006). Poor sleep is associated with higher plasma proinflammatory cytokine interleukin-6 and procoagulant marker fibrin d-dimer in older caregivers of people with Alzheimer's disease. Journal of the American Geriatrics Society, 54(3), 431–437.Google Scholar
von Känel, R., Ancoli-Israel, S., Dimsdale, J.E., et al. (2010). Sleep and biomarkers of atherosclerosis in elderly Alzheimer caregivers and controls. Gerontology, 56(1), 41–50. Epub ahead of print Dec 3, 2009. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844340/pdf/ger0056-0041.pdf.Google Scholar
Wilcox, S. & King, A.C. (1999). Sleep complaints in older women who are family caregivers. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 54(4), P189–P198.CrossRefGoogle ScholarPubMed
Wilson, K.G., Watson, S.T. & Currie, S.R. (1998). Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain. Pain, 75(1), 75–84.Google Scholar
Youngstedt, S.D. & Kripke, D.F. (2004). Long sleep and mortality: Rationale for sleep restriction. Sleep Medicine Reviews, 8(3), 159–174.Google Scholar