Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120
Presentation
Sleep Matters! Insights from Caregivers of Children with Physical Disabilities
Background: Sleep is an important determinant of health, but this relationship has received little attention in the economics literature. Understanding this relationship is important as socioeconomic status may influence sleep, and sleep may be associated with both the quantity and quality of life. This study examines sleep and health in caregivers of children with physical disabilities, a population at risk for health impairments from their role as caregivers.
Methods: Data for this study come from surveys involving caregivers of children with disabilities as part of an effort to obtain preference-weighted health outcomes of children and their primary caregivers. Surveys were administered to caregivers of children with spina bifida, traumatic brain injury, permanent hearing loss, craniofacial birth defects, and control children. Most of the surveys involved families in the state of Arkansas with the exception of children with brain injuries. All of the surveys asked about the preference-weighted health outcomes of the caregiver, average number of hours of sleep for the caregiver, family composition, and labor market outcomes. Separate relationships for sleep and health were estimated for both employed and unemployed caregivers.
Results: Caregivers of children with the most severe disabilities (traumatic brain injury and spina bifida) reported significantly less sleep relative to controls, with differences in sleep of between one half to three quarters of an hour per night. In multivariate models, there were pronounced differences in sleep between working and non-working caregivers. Working caregivers reported sleeping less if they were divorced, were more educated, or felt their children experienced pain. No differences in characteristics were noted among non-working caregivers. Caregivers with higher incomes reported more sleep in both groups. Multivariate models of caregiver preference-weighted health outcomes also indicated notable differences between working and non-working caregivers. Among working caregivers, sleep was less important to health production than for non-working caregivers. Also, the sleep health relationship reflected an optimum among non-working caregivers, but not among working caregivers. The traditional health gradient by income was evident among working caregivers, but there was no relationship among non-working caregivers.
Conclusions: Sleep plays an important role in health for caregivers of children with physical disabilities, but the impact differs for working and non-working caregivers. A possible explanation for the observed difference is that non-working caregivers require more time for caregiving of more severely disabled children and hence may obtain less sleep. This lack of sleep translates into poorer caregiver health. Given the importance of sleep to health, more research is needed with larger databases and different populations. Sleep may plausibly offer an even bigger impact on caregiver health among children with mental disabilities and this possibility needs to be explored.