Sleep Depression, and Psychosocial Risk Factors in Caregivers

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The objective of this career development award is to provide Dr. Lisa Meltzer with the experience and knowledge necessary to become an independent clinical researcher, bridging the fields of pediatric psychology and sleep medicine. Dr. Meltzer, a clinical psychologist, will accomplish this goal through a combination of directed reading, seminars, coursework, and mentored research. A highly qualified team of mentors will supervise her training and research, ensuring that she meets her goals. Dr. Meltzer will be examining sleep, depression, and psychosocial risk factors in pediatric caregivers. The specific aims of this proposal are:1) to characterize sleep patterns and daytime functioning (mood disturbances, fatigue, and executive functioning) in caregivers of ventilator-dependent children (VDC) and caregivers of healthy children, 2) to identify risk and protective factors related to caregiver burden and depressive symptoms in caregivers, 3) to examine sleep as a mediator of the relationship between caregiver burden and depressive symptoms in caregivers, and 4) to develop and evaluate a brief intervention designed to improve caregiver sleep, with the indirect benefit of improving symptoms of depression and fatigue. These aims will be accomplished with two studies: Study 1 is an evaluation of sleep, depressive symptoms, andpsychosocial risk factors in caregivers of children who are ventilator-dependent and caregivers of healthy control children. Study 2 is a pilot intervention to improve sleep quality and quantity in caregivers. This project will address gaps in the scientific literature related to the empirical measurement of caregiver burden for parents of children with chronic physical or mental health disorders, the impact of caregiving on mood, fatigue, and executive functioning, and how chronic sleep disruption is related to caregiver daytime functioning. In addition, this project will provide the applicant with expertise in the design, implementation, and analysis of clinical research and intervention studies, the use of actigraphy as an objective measure of sleep, and specialized training in sleep deprivation, sleep and depression, and ethical issues related to research with families of children with chronic physical or mental health disorders. The proposed study and career development activities will provide Dr. Meltzer with the skills to develop into an independent investigator with a program of research focusing on caregivers of pediatric populations. Relevance to Public Health: While the services of people who care for loved ones are estimated to be worth $257 billion, caregivers often put their own health and well-being at risk. Approximately 8% of children have a chronic condition that transforms parents into caregivers. This 24-hour a day job often results in elevated symptoms of depression. Sleep loss due to caregiving or stress may result in increased rates of negative functioning (e.g., mood and fatigue). This study will examine the relationship between sleep, depressive symptoms, and caregiver burden in pediatric caregivers, and develop ways to improve caregiver sleep.