The relationship between sleep quality, fatigue and psychological wellbeing amongst primary carers for those with brain injury

Objectives: The study aimed to investigate possible mediating factors that contribute to poor sleep quality in carers for those with brain injury (BI). More specifically, whether fatigue, anxiety, depression and perceived burden were associated with and/or predicted poor sleep in carers of those with brain injury. Methods: A cross-sectional correlational design was utilised. The Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression Scale (HADS) Fatigue Severity Scale (FSS), Zarit Buren Interview Short (ZBI-12) were completed by 237 carers of people with BI to assess sleep quality, psychological wellbeing and fatigue. Results: Carers demonstrated elevated levels of poor sleep quality, fatigue and poor psychological wellbeing. The results indicated there was a significant relationship between anxiety, depression, perceived burden, fatigue severity and sleep quality. Multiple regression analysis revealed that anxiety, depression, fatigue and burden explained 31.8% of variance in sleep quality. Depression and fatigue were significant predictors of sleep quality with fatigue symptomology being the strongest predictor of poor sleep amongst carers. Conclusion: Psychological wellbeing, perceived burden and fatigue are associated with sleep disturbances in carers with fatigue and depression predicting poor sleep quality. These results provide insight into an under-researched area and emphasise the necessity for support provisions which aim to improve sleep hygiene practices, improve psychological wellbeing and fatigue symptomology.