title: Positive affect is associated with fewer sleep problems in older caregivers but not noncaregivers.
abstract: OBJECTIVE
  Older adults who are depressed or are caregivers experience more sleep problems, whereas recent studies suggest that adults with high positive affect (PA) have fewer sleep problems. This study examined whether the associations of PA and depressive symptoms with sleep problems differed between caregivers and noncaregivers.
  
  
  METHODS
  Face-to-face interviews were conducted with 92 caregivers to a relative or friend with Alzheimer's disease or Parkinson's disease, and 137 noncaregivers aged 60 years and older (mean 73.8±7.9 years) from the Boston, Massachusetts, metropolitan area. Sleep problems were assessed using the Pittsburgh Sleep Quality Index (PSQI). Respondents were categorized as high PA (n = 122), low PA (n = 69), and depressive symptoms (n = 38) based on the Center for Epidemiologic Studies-Depression scale.
  
  
  RESULTS
  The mean PSQI score was 5.19 (SD = 3.26) and did not differ by caregiving status. In multivariable linear regression analyses among caregivers, those with high PA had significantly fewer sleep problems than their counterparts with low PA (adjusted mean PSQI score was 4.16 [SE = 0.50] vs. 5.69 [SE = 0.58], p = .05), whereas caregivers with depressive symptoms reported slightly more problems (adjusted mean 6.92 [SE = 0.80], p = .22). High PA and depressive symptoms were not associated with sleep problems among noncaregivers (adjusted mean PSQI scores were 4.88 [SE = 0.35], 5.38 [SE = 0.51], and 5.99 [SE = 0.73], respectively). Similar associations were found with PSQI scale components.
  
  
  CONCLUSIONS
  Results suggest that routine screening and interventions to increase PA may reduce sleep problems among older caregivers.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts. lfredman@bu.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fredman
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts.
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Gordon
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Massachusetts.
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts.
authors.forename: Sherri O
authors.initials: SO
authors.lastname: Stuver
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Caregiving; Depressive symptoms; Positive affect; Sleep