Temporal Associations Between Daily Affect, Sleep, and Physical Activity in Family Caregivers of Older Adults

TL;DR

This study explores how daily stress, sleep, and physical activity are linked in caregivers of older adults, finding that higher stress leads to worse sleep and less activity.

Contribution

The study reveals within-person temporal associations between psychological distress, sleep, and physical activity in caregivers.

Findings

Higher daily negative affect and stress are linked to shorter sleep duration and increased inactivity the next day.

Poorer sleep quality is associated with increased inactivity the following day.

No significant between-person differences were found in the associations studied.

Abstract

Informal caregiving can be psychologically taxing and may disrupt caregivers’ ability to maintain health-promoting behaviors. Psychological distress is linked to sleep problems and reduced physical activity, yet their temporal relationships remain underexplored in caregiving contexts. This study examined within- and between-person associations among psychological distress, sleep, and physical activity in caregivers of older adults (≥65 years) with chronic illness. Thirty caregivers (mean age, 57 years [SD = 10]; female, 93.3%; white race: 76.7%) completed daily surveys for 7 days, reporting negative affect (e.g., depressed, bored, irritated, dissatisfied with self, worried, and nervous), perceived stress each evening, and sleep quality each morning. Concurrently, they wore an accelerometer (ActiGraph GT9X-Link) to capture sleep and physical activity. Multilevel models accounted for person-level covariates (age, general health status, depression, sleep disorder) and day-level covariates (weekday/weekend, lagged variables). Within-person analyses showed that on the days with higher levels of negative affect and stress, caregivers were more likely to experience shorter sleep duration (B [95% CI] = -1.08 [-2.10, -0.06]; -0.95 [-1.47, -0.43]) and to spend longer time being inactive the following day (3.08 [1.10, 5.06]; 1.41 [0.38, 2.44]). On the days following shorter or poorer-quality sleep, caregivers were more likely to spend longer time being inactive (-0.37 [-0.65, -0.08]; 44.20 [20.97, 67.44]). No statistically significant between-person differences were observed. These findings highlight the daily interdependence of psychological distress, sleep, and physical activity. Interventions should incorporate real-time strategies that address daily stressors, promote sleep hygiene, and encourage physical activity to support sustainable caregiver health and prevent long-term decline.