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Cohabitating and non-cohabitating caregivers of people with dementia have significantly poorer sleep quality compared to non-dementia caregivers.

This nationwide cross-sectional study of 230,900 adults from the 2024 Korean Community Health Survey found that both cohabitating caregivers (OR 1.17, 95% CI 1.13-1.20) and non-cohabitating caregivers (OR 1.12, 95% CI 1.04-1.20) of people with dementia had significantly higher odds of poor sleep quality (PSQI ≥ 6) compared to non-dementia caregivers. The association was stronger for cohabitating caregivers, with the largest effects on sleep medication use (OR 1.61) and daytime dysfunction (OR 1.41).

Last updated: Jul 30, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association between caregivers of dementia and sleep quality : A nationwide population-based study.

observational

Lee S, Chung JH · Sleep & breathing = Schlaf & Atmung (2026)

Participants: N/A
Duration: cross-sectional (single time point in 2024)
Intervention: Cohabitation status (cohabitating vs. non-cohabitating vs. non-dementia caregivers) as a natural exposure
Outcome: Sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) total score and subcomponents (sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, sleep medication use, daytime dysfunction)
Effect Size: OR 1.17 (95% CI 1.13-1.20) for cohabitating caregivers; OR 1.12 (95% CI 1.04-1.20) for non-cohabitating caregivers
Population: 230,900 adults from the 2024 Korean Community Health Survey, including 3,709 cohabitating caregivers of people with dementia, 21,080 non-cohabitating caregivers, and 206,111 non-dementia caregivers

Result:

PubMed: 42474817DOI: 10.1007/s11325-026-03764-2

Mechanism Graph

Caregiving for a person with dementia increases psychosocial stress and depression (PHQ-9 scores were significantly higher in both caregiver groups)
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Chronic stress and depression disrupt sleep-regulating neuroendocrine pathways (e.g., HPA axis activation)
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Cohabitating caregivers face additional nighttime disruptions and care demands, further impairing sleep continuity and efficiency
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Result: Higher prevalence of poor sleep quality, particularly increased sleep medication use and daytime dysfunction

Limitations

  • ⚠Cross-sectional design prevents establishing causality between caregiving status and sleep quality
  • ⚠Reliance on self-reported PSQI and PHQ-9 may introduce recall bias and social desirability bias

Frequently Asked Questions

What is the PSQI cutoff used to define poor sleep quality in this study?▼

The study used a PSQI score of ≥ 6 to define poor sleep quality.

Did non-cohabitating caregivers also have worse sleep than non-dementia caregivers?▼

Yes, non-cohabitating caregivers had significantly higher odds of poor sleep quality (OR 1.12, 95% CI 1.04-1.20) compared to non-dementia caregivers, though the effect was slightly smaller than for cohabitating caregivers.

Which PSQI subcomponent showed the strongest association with cohabitating caregiving?▼

Sleep medication use had the strongest association (OR 1.61, 95% CI 1.44-1.80), followed by daytime dysfunction (OR 1.41, 95% CI 1.32-1.51).

What psychosocial factors were measured in the caregivers?▼

The study assessed stress and depression using the Patient Health Questionnaire-9 (PHQ-9), and both caregiver groups had significantly poorer scores on these measures compared to non-dementia caregivers.

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References

  1. 1.Lee S, Chung JH. "Association between caregivers of dementia and sleep quality : A nationwide population-based study.." Sleep & breathing = Schlaf & Atmung, 2026. PMID: 42474817 DOI: 10.1007/s11325-026-03764-2
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.