Caregiver reports of sleep problems in non-Hispanic white, Hispanic, and African American patients with Alzheimer dementia.
OBJECTIVE
Sleep problems are common in persons with dementing illnesses and among the most stressful patient behaviors for caregivers. Although studies have shown differences in sleep across ethnic groups, little information is available on ethnic differences among persons with dementia. The purpose of this study was to investigate possible ethnic differences in sleep problems among patients with Alzheimer dementia.


METHODS
Caregiver reports of 5 sleep- or circadian rhythm-related behavioral problems (behavior disturbance worse in the evening, difficulties falling asleep, frequent awakenings, early awakenings, and excessive daytime sleep) were evaluated in 395 patients who had received a diagnosis of Alzheimer disease after diagnostic evaluation. The average cognitive score of the groups suggested that they could be characterized as having moderately severe impairment. The frequency of sleep problems was then evaluated across subgroups defined by self-reported ethnicity (African American, Hispanic, and non-Hispanic white). As patient and caregiver characteristics may affect caregivers' reports of patients' behaviors, mixed effects regression models were used to adjust for patient and caregiver variables that might affect caregiver reports.


RESULTS
Analyses revealed ethnic differences in sleep or circadian rhythm disturbances. African American and Hispanic patients were reported to have more severe sleep disturbances than non-Hispanic whites. After correction for patient and caregiver variables that might have affected caregiver reports, differences between African Americans and others remained.


CONCLUSIONS
Sleep problems in patients with dementing illnesses are reported by caregivers with differing frequencies across groups of African Americans, Hispanics, and non-Hispanic whites. Clinicians should be aware of these differences in assessing sleep disturbance in patients with dementia as well as the potential effects of patient and caregiver variables on reports of these problems.
Ownby
Raymond L
RL
Department of Psychiatry and Public Health, Nova Southeastern University, Fort Lauderdale, FL, USA. ro71@nova.edu
Saeed
Muhammad
M
Wohlgemuth
William
W
Capasso
Robson
R
Acevedo
Amarilis
A
Peruyera
Gloria
G
Sevush
Steven
S
D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology; D000704:Analysis of Variance; D017028:Caregivers; D002940:Circadian Rhythm; D015897:Comorbidity; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*