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Neurology
Original research
Sleep disturbance in caregivers of individuals with Parkinsonism: a systematic review and meta-analysis
  1. Madeline Sprajcer1,
  2. Patrick J Owen2,
  3. Meagan E Crowther1,
  4. Kirsty Harper1,
  5. Charlotte Cecelia Gupta1,
  6. Sally A Ferguson1,
  7. Rosemary H Gibson3,
  8. Grace E Vincent1
  1. 1Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
  2. 2Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
  3. 3Sleep Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
  1. Correspondence to Dr Madeline Sprajcer; m.sprajcer{at}cqu.edu.au

Abstract

Objectives The global prevalence of Parkinsonism continues to rise given ageing populations. Individuals with Parkinsonism who have moderate or severe symptoms typically require a high level of care, including assistance with activities of daily living. This care is often provided across the 24-hour period by a family member or friend. It is likely that providing care significantly impacts the sleep duration and quality of the caregiver given overnight caring responsibilities, in addition to worry and stress associated with the caregiving role. The aim of this systematic review and meta-analysis was to investigate whether providing care to an individual with Parkinsonism was associated with disturbed caregiver sleep, and to identify associated factors that may contribute to disturbed sleep in this population.

Setting Five databases were electronically searched on 30 June 2021 including CINAHL, PubMed, PsycINFO, CENTRAL and EMBASE.

Participants Eligibility criteria included a population of caregivers whose care recipient has a form of Parkinsonism.

Primary and secondary outcome measures To be included in this systematic review, outcome measures of caregiver sleep (eg, sleep duration, sleep quality) were required.

Results Eighteen studies (n=1998) were included. Findings indicated that caregivers of individuals with Parkinsonism typically experience poor sleep quality (mean (95% CI): 5.6 (4.8 to 6.4) points on the Pittsburgh Sleep Quality Index), increased sleep latency and poor sleep efficiency.

Conclusions The degree of poor sleep quality was clinically significant. However, further investigation of sleep outcomes is required using sleep measurement tools tailored for this population (eg, measures that capture overnight sleep disruption by care recipient/s). Additionally, there is a need for appropriate individual and societal-level interventions to improve caregiver sleep.

PROSPERO registration number CRD42021274529.

  • parkinson-s disease
  • sleep medicine
  • social medicine
  • preventive medicine

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2022-062089

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    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

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    Supplementary materials

    Footnotes

    • Twitter @msprajcer, @cc_gupta

    • Contributors GEV, RHG, SF, MS and CCG conceptualised the study. Paper screening, data extraction and qualitative evaluation were performed by KH and MEC. Data collation and analyses were performed by PJO and MEC. MS is the guarantor. The manuscript was written by MS and KH with significant contributions from PJO, MEC, CCG, SF, RHG and GEV. PJO, MEC, CCG, SF, RHG and GEV also contributed to interpretation of findings and revision of the manuscript.

    • Funding MEC is supported by an Australian Government Research Training Programme (RTP) Scholarship.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.