title: PEAR model and sleep outcomes in dementia caregivers: influence of activity restriction and pleasant events on sleep disturbances.
abstract: BACKGROUND
  Sleep disturbance is a common consequence of providing care to a loved one with Alzheimer's disease (AD). We explored the usefulness of the Pleasant Events and Activity Restriction (PEAR) model for predicting multiple domains of sleep disturbance.
  
  
  METHODS
  Our sample consisted of 125 spousal AD caregivers. Participants completed the Pittsburg Sleep Quality Index (PSQI) and were questioned regarding the frequency with which they engaged in pleasant events and the extent to which they felt restricted in engaging in social and recreational activities in the past month. Participants were classified into one of three groups: HPLR = High Pleasant Events + Low Activity Restriction (= reference group; N = 38); HPHR/LPLR = either High Pleasant Events + High Activity Restriction or Low Pleasant Events + Low Activity Restriction (N = 52); and LPHR: Low Pleasant Events + High Activity Restriction (N = 35). These three groups were compared on the seven subscales of the PSQI.
  
  
  RESULTS
  Significant differences were found between the HPLR and LPHR groups on measures of subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance, and daytime dysfunction. Additionally, significant differences were found between the HPLR and HPHR/LPLR groups on subjective sleep quality, sleep latency, and habitual sleep efficiency, and between the HPHR/LPLR and LPHR groups on sleep disturbance and daytime dysfunction.
  
  
  CONCLUSIONS
  This study provides broad support for the PEAR model and suggests that interventions focusing on behavioral activation may potentially provide benefits to non-affective domains including sleep.
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla 92093-0680, USA.
authors.forename: Raeanne C
authors.initials: RC
authors.lastname: Moore
authors.forename: Alexandrea L
authors.initials: AL
authors.lastname: Harmell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chattillion
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*