Sleep Duration and the Cortisol Awakening Response in Dementia Caregivers Utilizing Adult Day Services
Sleep Duration and the Cortisol Awakening Response in Dementia Caregivers Utilizing Adult Day Services
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DOI：
10.1037/hea0000276
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发表时间：
2016-05-01
影响因子：
4.2
通讯作者：
Zarit, Steven H.
中科院分区：
文献类型：
--
作者：
Leggett, Amanda N.;Liu, Yin;Zarit, Steven H.
目的：睡眠问题在照顾者中很常见，并且与身心健康的损害有关。皮质醇是压力过程的生物标志物，可能将睡眠与护理人员随后的健康变化联系起来。目前的研究探讨了睡眠时间是否与皮质醇觉醒反应（CAR）直接相关，或者是否受成人日间服务（ADS）使用的影响，这是一种先前发现的干预措施，通过减少压力暴露来影响日常CAR。方法：协会进行了检查，在照顾者（N = 158）的个人与痴呆症（IWD）的日子，IWD出席ADS和天，IWD不出席ADS。连续8天收集数据。照顾者主要是女性（87.3%），平均年龄为61.59岁。一个多层次的增长曲线模型测试了今天的ADS使用和昨晚的睡眠时间与今天的CAR作为结果的相互作用的关联。结果如下：ADS使用和人内睡眠时间之间的相互作用是显着的，当一个人的睡眠时间比他们的平均水平长，但不使用ADS，他们有一个较小的或钝化的CAR。另一方面，当一个人的睡眠时间超过平均水平并使用ADS时，他们的CAR较高但不显著。睡眠时间比平时短与动态上升有关，无论是否使用ADS。结论：研究结果表明，ADS使用缓和睡眠持续时间和CAR之间的关联，比平均睡眠时间长，与钝化，失调的皮质醇模式，只有在非ADS天。
Objective: Sleep complaints are common among caregivers and are associated with detriments in mental and physical health. Cortisol, a biomarker of the stress process, may link sleep with subsequent health changes in caregivers. The current study examines whether sleep duration is directly associated with the cortisol awakening response (CAR), or whether it is moderated by Adult Day Services (ADS) use, an intervention found previously to influence daily CAR by reducing stressor exposure. Method: Associations were examined in caregivers (N = 158) of individuals with dementia (IWD) on days when IWDs attended ADS and days when IWDs did not attend ADS. Data were gathered over 8 consecutive days. Caregivers were primarily female (87.3%) with a mean age of 61.59. A multilevel growth curve model tested the association of an interaction of today's ADS use and last night's sleep duration with today's CAR as the outcome. Results: The interaction between ADS use and within-person sleep duration was significant such that when an individual sleeps longer than their average but does not use ADS, they have a smaller or blunted CAR. On the other hand when an individual sleeps longer than their average and uses ADS, they have a higher but nonsignificant CAR. Sleeping shorter than usual was associated with a dynamic rise regardless of ADS use. Conclusions: Findings indicate that ADS use moderates the association between sleep duration and CAR such that longer than average sleep is associated with blunted, dysregulated cortisol patterns only on non-ADS days.