The Moderating Effect of Resilience on the Associations Between Caregiving Stressors and Sleep Outcomes Among African American Caregivers of Persons Living with Dementia

PURPOSE: Caring for persons living with dementia (PLwD) involves high levels of physical demands and emotional burden that may undermine caregivers' sleep quality. Few studies have examined sleep among African Americans caregivers of PLwD despite their underrepresentation in dementia research and poorer sleep outcomes compared to other racial and ethnic groups. This study examines the relationships between caregiving stressors and sleep and the moderating effect of resilience on these associations among African American caregivers of PLwD. MATERIALS AND METHODS: Data were drawn from a community study of 88 African American caregivers of PLwD. Caregiving stressors included assistance with daily activities and role overload. Resilience refers to the ability to adapt to or recover from adversity. Sleep outcomes included sleep disturbance and sleep satisfaction. Multiple linear regressions with interaction terms were used. RESULTS: Assistance with daily activities and role overload were positively associated with sleep disturbance. These associations were stronger at higher levels of resilience than at lower levels. DISCUSSION: Findings reveal the nuanced role of resilience among African American caregivers of PLwD; its health benefits may be conditional, particularly as caregiving stressors increase. Heightened resilience may overemphasize self-reliance, increasing individual burden and reducing support network use, and ultimately increasing vulnerability to sleep disturbance. CONCLUSION: Findings highlight implications for social work by underscoring the need to understand how resilience operates within the cultural context of the African American community and to develop culturally responsive practice and policies that address caregiving stressors and strained resilience among African American caregivers of PLwD.