Quality of sleep among caregivers of Alzheimer disease patients: cross-sectional study from Saudi Arabia


  • Adel Ali Alhazzani Neurology unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia http://orcid.org/0000-0002-9884-2243
  • Mohammed Saeed Alqahtani Neurology Resident, Armed Forces Hospital–Southern Region / King Fahad Hospital-Jeddah, Saudi Arabia




Sleep quality, AD, Caregivers


Background: Alzheimer’s disease (AD) is the most common cause of dementia and represents a major health burden. Characterized by gradual decline in cognitive function, leading to dependency and changes in behavior and personality. Patients with AD need continuous care, which may affect the caregiver’s quality of life, including sleep quality. The aim of this study was to assess sleep quality among AD patients’ caregivers and its determinants in Aseer region, Saudi Arabia.

Methods: A descriptive cross-sectional study was conducted among 110 caregivers of AD patients at Abha Mental Health Hospital. The caregivers’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A global PSQI cutoff value of 5 or higher was considered as indicative of poor sleep quality.

Results: Female caregivers’ constituted 53.6% of the sample, and 50% were below the age of 40 years. The majority of the caregivers (64.5%) reported that they had experienced sleep disturbances during past month and 10% needed medication approximately three or more times a week to help them sleep. Almost two-thirds of the caregivers (60%) spent more than 10 hours daily with their patients. Regarding sleep hygiene, 40.9% of the caregivers rated their sleep quality as poor and only 10.9% had good sleep quality.

Conclusions: The burden on caregivers of AD patients is considerable and often under-recognized; in particular; most caregivers in the Saudi population were young and of working age. Poor sleep quality affected the caregivers’ day life activities but typically remained undertreated.


Alzheimer's Association. 2016 Alzheimer's disease facts and figures. Alzheimer's & Dementia. 2016;12:459-509.

Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:158.

Mendez MF. Early-onset Alzheimer's disease: non-amnesic subtypes and type 2 AD. Archives of medical research. 2012;43:677-85.

Tappen RM, Williams C, Fishman S, Touhy T. Persistence of self in advanced Alzheimer's disease. Image. Journal of Nursing Scholarship. 1999;31:121-5.

Shin IS, Carter M, Masterman D, Fairbanks L, Cummings JL. Neuropsychiatric symptoms and quality of life in Alzheimer disease. American journal of geriatric psychiatry. 2005;1:469-74.

Querfurth HW, La Ferla FM. Alzheimer's disease. New England Journal of Medicine. 2010;362:329-44.

Todd S, Barr S, Roberts M, Passmore AP. Survival in dementia and predictors of mortality: a review. International Journal of Geriatric Psychiatry. 2013;28:1109-24.

Biegel DE, Sales E, Schulz R. Family caregiving in chronic illness: Alzheimer's disease, cancer, heart disease, mental illness, and stroke. Sage Publications, Inc. 1991.

Mahoney R, Regan C, Katona C, Livingston G. Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. American Journal of Geriatric Psychiatry. 2005;1:795-801.

Farran CJ, Loukissa D, Perraud S, Paun O. Alzheimer's disease caregiving information and skills. Part I: Care recipient issues and concerns. Research in nursing & health. 2003;26:366-75.

Centers for Disease Control and Prevention. Caregiving for person with Alzheimer’s disease or a related dementia. https://www. cdc. gov/aging/caregiving/alzheimer. htm. 2019. Accessed on 25th May 2019.

Alzheimer's Association. 2019 Alzheimer's disease facts and figures. Alzheimer's & Dementia. 2019;15:321-87.

Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62:126-37.

de Vugt ME, Jolles J, van Osch L. Cognitive functioning in spousal caregivers of dementia patients: findings from the prospective MAASBED study. Age Ageing. 2006;35:160-6.

Oken BS, Fonareva I, Wahbeh H. Stress-related cognitive dysfunction in dementia caregivers. J Geriatr Psychiatry Neurol. 2011;24:191-8.

McKibbin CL, Ancoli-Israel S, Dimsdale J. Sleep in spousal caregivers of people with Alzheimer's disease. Sleep. 2005;1:1245-50.

Buysse DJ, Reynolds CF, Monk TH. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry res. 1989;28:193-213.

Raggi A, Ferri R. Sleep disorders in neurodegenerative diseases. European journal of neurology. 2010;17:1326-38.

Gaugler JE, Edwards AB, Femia EE. Predictors of institutionalization of cognitively impaired elders: Family help and the timing of placement. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2000;1:247-55.

Harper DG, Stopa EG, McKee AC. Dementia severity and Lewy bodies affect circadian rhythms in Alzheimer disease. Neurobiology of aging. 2004;1:771-81.

Tractenberg RE, Singer, CMCummings JL. The Sleep Disorders Inventory: an instrument for studies of sleep disturbance in persons with Alzheimer's disease. Journal of sleep research. 2003;12:331-7.

Moran M, Lynch CA, Walsh C. Sleep disturbance in mild to moderate Alzheimer's disease. Sleep medicine. 2005;1:347-52.

Cupidi C, Realmuto S, Coco GL. Sleep quality in caregivers of patients with Alzheimer's disease and Parkinson's disease and its relationship to quality of life. International Psychogeriatrics. 2012;24:1827-35.

McCurry SM, Logsdon RG, Teri L. Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. Sleep medicine reviews. 2007;11:143-53.

Ritchie K. Behavioral disturbances of dementia in ambulatory care settings. Int Psychogeriatr. 1996;8:439-42.

McCurry SM, Teri L. Sleep disturbance in elderly caregivers of dementia patients. Clin Gerontol. 1995;16:51-66.

Alhazzani AA, Alqahtani M, Alshbriqe A. Prevalence of complications associated with Alzheimer disease. Journal of the Neurological Sciences. 2017;15:315.

Alshammari SA, Alzahrani AA, Alabduljabbar KA. The burden perceived by informal caregivers of the elderly in Saudi Arabia. Journal of family & community medicine. 2017;24:145.




How to Cite

Alhazzani, A. A., & Alqahtani, M. S. (2021). Quality of sleep among caregivers of Alzheimer disease patients: cross-sectional study from Saudi Arabia. International Journal Of Community Medicine And Public Health, 8(6), 2705–2711. https://doi.org/10.18203/2394-6040.ijcmph20211972



Original Research Articles