title: Sleeping with one eye open: the sleep experience of family members providing palliative care at home.
abstract: OBJECTIVE
  To empirically describe the sleep experience of family caregivers (n=13) of advanced cancer patients.
  
  
  METHODS
  Mixed methodology using: family interviews; Epworth Sleepiness Scale (ESS); Pittsburgh Sleep Quality Index (PSQI); and actigraphy measurement. Qualitative data analysis utilized constant comparative content techniques. Actiware for the actigraphy data and the Statistical Package for the Social Sciences-15 (SPSS-15) generated descriptive and correlation statistics.
  
  
  RESULTS
  The overarching theme "sleeping with one eye open" captures the vigilant nature of caregivers' sleep experiences. Caregiver narratives were validated by quantitative findings: 5 of the family caregivers (38.5 percent) had an ESS score > or =11 indicative of excessive daytime sleepiness, all caregivers had a PSQI global score >5 indicative of moderate to severe sleep problems, and actigraphy scores--including total sleep time, sleep efficiency, and time awake after sleep onset--fell beyond normal values documented in the literature.
  
  
  CONCLUSIONS
  Impeccable assessment of the patient's and family's sleep status, sleep education, intervention strategies, and high-quality respite services are critical in community-based palliative care.
authors.affiliation: Winnipeg Regional Health Authority Palliative Care Program, and Canadian Virtual Hospice, 10 Doral Way, Headingly, Manitoba, Canada. bhearson@wrha.mb.ca
authors.forename: Brenda
authors.initials: B
authors.lastname: Hearson
authors.forename: Susan
authors.initials: S
authors.lastname: McClement
authors.forename: Diana E
authors.initials: DE
authors.lastname: McMillan
authors.forename: Michael
authors.initials: M
authors.lastname: Harlos
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D033262:Narration; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care; D012892:Sleep Deprivation / Q000517:prevention & control / Q000523:psychology