Caring for a parent and not sleeping: what can I do?

If caring for a parent leaves you short of sleep, you are not alone. The US National Institute on Aging (NIA) lists trouble sleeping or not getting enough sleep among the signs of caregiver stress, and a study in Chiang Mai found that family carers averaged 55 years old, with strain on time the most common kind. What helps: aim for 7 or more hours, share the night-time care with other family members so you get some full nights, keep regular sleep and wake times, ask for specific help, find out about community long-term care in your area, and see a doctor if the tiredness or low mood goes on.

This article is about the carer's own sleep. For why older parents wake up at night and how to help them sleep, see Older parents waking up at night: how can family help?

Why does caring for a parent cut into my sleep?

Care does not stop at night

A parent who needs help to get to the toilet, to turn over, or who wakes up confused or calling out, needs someone at night as well as during the day. Each time you get up, your own sleep is broken, and it can take a while to fall asleep again.

Strain on time is the most common

A study of 867 pairs of older adults and their main family caregivers in Chiang Mai, by Aung and colleagues (2021), measured five kinds of caregiver strain. The most common was strain on time (25.7%), followed by physical strain (21.2%), which covers things like tiredness and aches. A study of 120 caregivers of bedridden older adults in a central Thai province found they spent an average of 6.84 hours a day on care. Hours spent on care come out of the hours left for work, family and sleep.

Stress and sleep go together

A 2022 study of 72 Thai family caregivers, by Sanprakhon and colleagues, looked at people caring for older relatives whose memory and everyday abilities had declined, who were receiving community long-term care. The researchers concluded that the caregivers had poor sleep quality (an average score of 12.44 on the Pittsburgh Sleep Quality Index, or PSQI). Those who felt more stressed by caregiving tended to sleep worse. This was a small study at one point in time, so it shows a link, not which came first.

How common is caregiver strain in Thailand?

What Thai studies found

Reading the numbers

Each study used its own questionnaire, so the figures cannot be compared directly. Most were surveys at one point in time in particular provinces, and people rated themselves. Taken together, they show two things: the 2021 national survey found a middle burden score of 3 out of 10, which the researchers read as low overall, but a sizeable group, especially those giving many hours of care, carry a heavy load. And the carers themselves are often not young: in Chiang Mai their average age was 55, and more than a third were 60 to 69.

How can I get more sleep while caring for a parent?

Know what you are aiming for

The NIA advises caregivers to prioritise sleep: aim for 7 to 9 hours a night, develop a relaxing bedtime routine, and go to sleep and get up at the same time each day. The US CDC recommends 7 or more hours for adults aged 18 to 60, 7 to 9 hours at 61 to 64, and 7 to 8 hours from 65. If you are far below that most nights, the gap is worth taking seriously.

Share the night

If several family members live nearby, taking turns on night duty is one of the simplest changes. Even one or two nights a week give the main carer some full nights of sleep. Ways to share it:

• Split the week: one person covers weeknights, another covers weekends.
• Split the night: one person is on call until 2 a.m., another after that.
• Ask a relative who works during the day to cover the evening, so the main carer can go to bed early.

Keep regular sleep times

Broken nights are harder to cope with when bedtime also moves around. Going to bed and getting up at about the same time every day, as the NIA and CDC suggest, keeps at least part of your routine steady. The CDC also advises turning off devices at least 30 minutes before bed and avoiding caffeine in the afternoon or evening and alcohol before bedtime.

Make night-time care easier

Some changes at home can cut down the number of times you need to get up, for example a clear, lit path from your parent's bed to the bathroom, or sleeping closer to them so you hear them sooner. Helping your parent sleep better at night also helps your sleep: see Older parents waking up at night: how can family help?

How do I ask my family for help?

Many carers find this the hardest part. The NIA notes that many caregivers later say they did too much on their own and wish they had asked family and friends for more support.

Tips from the NIA

The NIA also suggests that family members who are not the main carer offer to stay with the older person for one afternoon a week, or arrange regular respite, so the main carer can have some time off.

What help is there for family caregivers in Thailand?

Community long-term care

Thailand runs community-based long-term care under the Universal Coverage Scheme to support family caregiving for dependent older people. It is organised at subdistrict level and involves volunteer caregivers. Ask your local hospital or subdistrict health centre whether your parent can be assessed and what help is available where you live.

Breaks from caring

The UK's NHS explains that a break from caring gives you time to look after yourself and helps stop you becoming exhausted and run down. Its examples include day care, a paid carer at home, a short stay in a care home, help from family and friends, and a volunteer who keeps the person company for a while. Services differ in Thailand, but the idea is the same: a few hours or a few days when someone else is responsible.

Someone to talk to

In Thailand, the 1323 mental health hotline is free to call, 24 hours a day.

What signs of strain should I watch for, and when should I see a doctor?

Signs of caregiver stress

The NIA lists these signs of caregiver stress:

• feeling exhausted, overwhelmed or anxious
• becoming easily angered or impatient
• feeling lonely or disconnected from others
• having trouble sleeping or not getting enough sleep
• feeling sad or hopeless, or losing interest in things you used to enjoy
• frequent headaches, pain or other physical problems
• not having time to exercise or prepare healthy food for yourself
• skipping showers or other personal care
• using alcohol or drugs, including prescription medicines, more than you should

The NIA advises not waiting until you are completely overwhelmed, and learning your own warning signs.

Tell your doctor you are a carer

The NIA advises telling your doctor that you are a caregiver, so they can advise you on your physical and mental health and may know about support in your area. If you feel anxious, frustrated or down, the NIA suggests asking your doctor about a counsellor.

If tiredness or short sleep goes on and affects daily life, see a doctor. Before taking anything new to help you sleep, ask a doctor or pharmacist.

Get help straight away

If you have thoughts of harming yourself, or of harming the person you care for, get help now: call 1323 or go to the nearest hospital emergency department.