Daily Sleep and Anxious and Depressive Symptoms Among Dementia Caregivers-The Mediation of Cortisol Total Output on High- and Low-Stress Days.
Daily Sleep and Anxious and Depressive Symptoms Among Dementia Caregivers-The Mediation of Cortisol Total Output on High- and Low-Stress Days.
复制标题
痴呆症护理人员的日常睡眠与焦虑和抑郁症状——皮质醇总输出在高压力和低压力日的调节。
DOI：
10.1093/geronb/gbac074
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Lorenz,Rebecca
中科院分区：
文献类型：
--
作者：
Liu,Yin;Fauth,ElizabethB;Fleming,DanielJM;Lorenz,Rebecca
目的痴呆症家庭照顾者报告睡眠和情绪不佳，通常归因于慢性压力和管理频繁的日常压力源。虽然许多研究使用这些指标的全球回顾性报告，但本研究从压力源暴露和反应的生物心理社会角度，在日常水平上探讨了睡眠、负面影响、压力生物标志物和高/低压力环境之间的联系机制。（法师= 61.97，SD =10.66）每周至少有2天在家中提供护理和使用成人日间服务（ADS）。护理人员报告他们的就寝时间，清醒时间，睡眠质量，和夜间问题的人与痴呆症（PwD）每天连续八天，同时报告非护理压力源，负面影响，并提供五个唾液皮质醇样本，每天。我们进行了多层次的分析，以检查是否照顾者的睡眠特点过夜（即，总卧床时间、质量和PwD睡眠问题）与他们在使用ADS的日子与非ADS日子（即，低压力与高压力），以及皮质醇每日总输出作为曲线下面积（AUC g）是否介导了人内和人间水平的直接关联。non-ADS）天，当照顾者有一个较长的时间在床上比平时的前一天晚上，他们不太焦虑的第二天，直接关联是通过降低皮质醇AUCg在day.DiscussionStaying在床上比平时更长的时间之前，即将到来的高压力的一天可能有助于痴呆症的家庭照顾者更好地调节皮质醇应激反应和焦虑症状的统计介导。
ObjectivesDementia family caregivers report poor sleep and mood, typically attributed to chronic stress and managing frequent daily stressors. Although many studies use global retrospective reports of these indicators, the current study examines mechanisms linking sleep, negative affect, stress biomarkers, and high-/low-stress contexts at the daily level, from the biopsychosocial perspective of stressor exposure and reactivity.MethodOne hundred seventy-three caregivers (Mage= 61.97,SD =10.66) were providing care at home and used adult day services (ADS) at least 2 days a week. Caregivers reported their bedtime, wake time, sleep quality, and nighttime problems of the person with dementia (PwD) daily for eight consecutive days, concurrently reporting noncare stressors, negative affect, and providing five salivary cortisol samples per day. We conducted multilevel analysis to examine whether caregiver sleep characteristics overnight (i.e., total time in bed, quality, and PwD sleep problems) were associated with their anxious and depressive symptoms on days where ADS were utilized versus non-ADS days (i.e., low stress vs. high stress), and whether cortisol daily total output as area under the curve (AUCg) mediated the direct associations, at the within- and between-person levels.ResultsOn high-stress (i.e., non-ADS) days when caregivers had a longer time in bed than usual the night before, they were less anxious on the following day; the direct association was statistically mediated through lower cortisol AUCg during the day.DiscussionStaying longer in bed than usual before an upcoming high-stress day may help dementia family caregivers better regulate cortisol stress reactivity and anxious symptoms.