Unpaid caregiving and sleep disturbance in mid- and later life in England

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Unpaid caregivers provide most of the support for individuals with social care needs in England and maintaining caregiver health and wellbeing is important to sustaining their role. Sleep disturbance has been linked to poorer health and lower quality of life, and, among caregivers, may be a reason for ceasing care. However, our understanding of caregiver sleep from longitudinal and population-based studies is limited. This thesis investigated relationships between caregiving and sleep disturbance among women and men aged fifty and over in England. It was guided by the stress process framework and insights from the sociology of sleep. The conceptual framework for the study focused on characteristics of caregiving and periods of transition and stability likely to be stressful, as well as the influence of gendered social roles, and changes in partner health among couples. The research aimed to identify, first, how care hours and relationship to the care recipient were associated with sleep disturbance; second, differences in patterns of sleep disturbance across a care episode and by care duration, and third, associations with co-resident care and partner health in the context of cohabiting couples. Fixed effect models were the main statistical approach used to analyse change within individuals, on data drawn primarily from Waves 4, 6 and 8 of the English Longitudinal Study of Ageing (ELSA). Wave 1 of the ELSA COVID-19 sub-study was also analysed, during a period likely to exacerbate stressors for some caregivers. Results indicated limited associations between some aspects of unpaid care, partner health and sleep disturbance. Spouse care and care of 20 or more hours per week were linked to small increases in the probability of sleep disturbance among men. Among women, sleep disturbance was related to care durations of two or more waves, and unexpectedly, ceasing care, while depressive symptoms accounted for associations in some analyses. Among couples, no association was found with co-resident care, but several partner health conditions were linked to sleep disturbance among women. As expected, changes in individual health were strongly associated with sleep disturbance. Limited evidence supported hypothesised sleep disturbance linked to caregiving, however, sleep disturbance may be more transient than could be measured by the data available. Future research would benefit from availability of more frequently measured sleep data enabling closer modelling of changing circumstances and sleep.
Date of Award1 Sept 2022
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorKaren Glaser (Supervisor) & Laurie Corna (Supervisor)

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