Sleep-wake disturbances in patients with cancer and their informal caregivers: a matter of dyads

Background: Changes in habitual sleep are among the most remarkable and important concerns of both patients with cancer and their informal carers. A dyadic approach in the assessment and management of sleep problems in patients and carers is a promising method of exploring concurrent sleep disturbances and establishing associations between sleep and sleep-impairing factors that may co-vary in the members of the dyad. The purpose of the present mini-review article was to discuss the current evidence, as well as highlight areas where future research is warranted. Patients & Methods: An electronic search for original peer-reviewed articles published between January 1990 and July 2011 in three research and evidence databases (MedLine, CINAHL, EMBASE) was carried out using a wide range of keywords and free-text terms. Cancer care-related evidence was complemented by additional data derived from studies conducted with married couples or in the context of other chronic illnesses. Results: Concurrent and comparable nocturnal sleep disruptions might be evident, where poor sleep quality, decreased sleep duration, and multiple awakenings may correlate with each other within the dyad. Care recipients' and caregivers' night and day rest patterns can be synchronised, as caregivers organise their sleep around the patient. Conclusion: More systematic, dyadic research is warranted to enhance development of intervention protocols for the comprehensive management of sleep disorders in this population throughout the illness experience. These interventions will ensure that sleep patterns are assessed in depth and are managed in a concurrent manner to achieve a concurrent increased level of well-being of patient-caregiver dyads.