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The Effect of a Child’s Illness on Maternal Sleep and Function

Caregiver sleep quality mediates the relation between child health and caregiver depression and fatigue.

Caring for a family member or a loved one with a chronic medical condition often requires both day and night attention, which might actually affect caregiver health and quality of life. Most of the existing literature has focused on the caregivers of adults and has found that sleep disruption is associated with depressive symptoms and emotional distress in the caregivers. Few surveys have examined caregivers of pediatric subpopulations, and little is known about the relative contribution of sleep disruptions in the occurrence of daytime impairment.

During several phone-based interviews, 118 mothers of children with and without chronic medical conditions (29 mothers of ventilator-dependent children, 42 of children with cystic fibrosis, and 47 of children with no chronic illness) completed several validated, self-report questionnaires about their sleep patterns, their mood and fatigue, and their child’s health. Overall, mothers of ventilator-dependent children reported significantly more depressive symptoms, fatigue, and night awakenings compared with mothers of healthy children. They also reported significantly shorter total-sleep time and poorer sleep quality compared with mothers of children with cystic fibrosis and mothers of healthy children. Finally, significantly more mothers of ventilator-dependent children reported waking at least once a week to perform nighttime care duties compared with mothers of children with cystic fibrosis and healthy children (52%, 26%, and 9%, respectively). When all variables were considered, the investigators found significant correlations between child health status and the occurrence of caregiver depression and fatigue, and these associations were mediated by caregiver sleep quality.

Comment: It is not surprising that caregiver depression and fatigue were associated with child health status. Sleep quality appears to play a major role in this association. However, whether sleep problems preceded the occurrence of fatigue and depression in this study is unclear. Nonetheless, the message is clear — getting enough rest is vital. Clinicians should ask caregivers of children with chronic conditions about their own sleep patterns and should stress the importance of quality sleep to their overall well-being and ability to perform their daytime responsibilities.

— Claudio N. Soares, MD, PhD

Published in Journal Watch Women's Health November 30, 2006

Citation(s):

Meltzer LJ and Mindell JA. Impact of a child’s chronic illness on maternal sleep and daytime functioning. Arch Intern Med 2006 Sep 18; 166:1749-55.

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