RELATIONSHIP BETWEEN WORK OVERLOAD AND SLEEP-WAKE PATTERN, SLEEP QUALITY AND DAYTIME SLEEPINESS OF CAREGIVERS: A MIXED METHODS STUDY
Home Care Services. Caregiver Burden. Sleep Initiation and Maintenance Disorders. Occupational Health.
Introduction: The act of caring for an elderly person involves daily changes, responsibilities, tasks and time availability, in addition to having negative implications for the health of the caregiver, which can affect the quality of life and sleep-wake pattern. Objective: To evaluate the relationship between work overload and the sleep-wake pattern, sleep quality and daytime sleepiness of elderly caregivers. Methodology: mixed methods, sequential study, in which 73 randomly selected caregivers of elderly people from a city in Paraíba participated. Data were collected between April and August 2023 using the following instruments: sociodemographic and occupational questionnaire; Zarit overhead inventory; Pittsburgh Sleep Quality Index; sleep diary, Maldonado Sleepiness Scale and a semi-structured script for the in-depth interview. Quantitative data were analyzed using descriptive and bivariate statistics, considering significance when p-value < 0.05. The qualitative data were processed by the IRAMUTEQ software with support from descending hierarchical classification, and subsequently analyzed in the light of Bardin's methodological framework. Results: 47.9% of the total sample had poor sleep quality, which was associated with female sex (p=0.018), urban living area (p=0.0001) and home occupation (p=0.0001). When considering the ZARIT stratifications, 67.1% of caregivers present a moderate to severe degree of work overload, which was associated with poor quality of the caregiver's sleep (p=0.0001), indicating that the greater the degree of overload the caregiver's sleep quality was worse (p = 0.727). Regarding the sleep/wake pattern, later bedtimes and wake times were observed on the weekend (p=0.0001) compared to the week, with no differences in time in bed. The average irregularities (deltas) observed in bedtime, wake-up time and sleep duration were 37.28 ± 24.53min, 39.46 ± 18.0min and 51.88 ± 43.67min, respectively. There was a higher prevalence of daytime sleepiness stratified on weekdays when compared to weekend days (p=0.025). When comparing the variables according to area of residence, a statistically significant relationship was obtained with the rural area for the occupation of farmer (p=0.0001) and caregiver, primarily developed by grandchildren (p=0.038). The urban area had worse sleep quality (p=0.008), shorter sleep duration on weekdays (p=0.027) and weekends (p=0.001) in addition to a higher average wake-up delta (p=0.018), indicating later waking times. Morningness was more prevalent regardless of the area of residence. The qualitative data corroborate the findings of the quantitative set, which are presented in a thematic category, which reveals the caregiver's perception of unsatisfactory sleep and the habits that characterize the care activity as compromising the sleep/wake cycle and the other biopsychosocial dimensions of the individual. Conclusions: The convergence of data indicates the existence of a relationship between care and worse sleep conditions for the caregiver, awakening the need for interventions in the scenario of these professionals.