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Article

Bidirectional Relationship Between Insomnia and Depressive Symptoms in Family Caregivers of People with Dementia: A Longitudinal Study †

by
Lucía Jiménez-Gonzalo
1,*,
María Márquez-González
2,
Carlos Vara-García
1,
Rosa Romero-Moreno
1,
Javier Olazarán
3,
Roland von Känel
4,
Brent T. Mausbach
5 and
Andrés Losada-Baltar
1
1
Department of Psychology, Universidad Rey Juan Carlos, 28922 Madrid, Spain
2
Department of Biological and Health Psychology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
3
Department of Neurology, Hospital General Universitario Gergorio Marañon, 28007 Madrid, Spain
4
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, 8032 Zürich, Switzerland
5
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
*
Author to whom correspondence should be addressed.
This is an oral communication at 63 National Congress of the Spanish Society of Geriatrics and Gerontology, Pamplona, Spain, 7 June 2023.
Behav. Sci. 2025, 15(7), 936; https://doi.org/10.3390/bs15070936
Submission received: 10 April 2025 / Revised: 7 July 2025 / Accepted: 7 July 2025 / Published: 10 July 2025
(This article belongs to the Special Issue Psychosocial Care and Support in Dementia)

Abstract

Bidirectionality between insomnia and depression is well documented in general and clinical populations but remains under-researched in family caregivers of people with dementia. This study aimed to explore this relationship using a longitudinal design with 155 family caregivers assessed annually over three years. Data collected included sociodemographic information, health behaviors, medical data, caregiving stressors, and depressive and insomnia symptoms. Two linear mixed models were tested: Model 1 considered insomnia symptoms as the independent variable and depressive symptoms as the outcome; Model 2 considered depressive symptoms as the independent variable and insomnia symptoms as the outcome. The results showed that caregivers with more insomnia symptoms over time had significantly higher depressive symptoms, even after adjusting for covariates. Insomnia accounted for an additional 7.47% of the variance, with a total explained variance of 57.93%. Conversely, higher depressive symptoms over time were associated with increased insomnia. Depressive symptoms explained an additional 7.28% of the variance, with a total explained variance of 25.74%. These results were consistent with previous studies on non-caregiving populations, adding empirical evidence to the notion that both insomnia and depression may operate as a risk factor for the other disorder. Caregiver support interventions could improve their psychological well-being if they incorporate sleep-focused strategies.
Keywords: caregiving; stress; distress; sleep; mixed models caregiving; stress; distress; sleep; mixed models

Share and Cite

MDPI and ACS Style

Jiménez-Gonzalo, L.; Márquez-González, M.; Vara-García, C.; Romero-Moreno, R.; Olazarán, J.; von Känel, R.; Mausbach, B.T.; Losada-Baltar, A. Bidirectional Relationship Between Insomnia and Depressive Symptoms in Family Caregivers of People with Dementia: A Longitudinal Study. Behav. Sci. 2025, 15, 936. https://doi.org/10.3390/bs15070936

AMA Style

Jiménez-Gonzalo L, Márquez-González M, Vara-García C, Romero-Moreno R, Olazarán J, von Känel R, Mausbach BT, Losada-Baltar A. Bidirectional Relationship Between Insomnia and Depressive Symptoms in Family Caregivers of People with Dementia: A Longitudinal Study. Behavioral Sciences. 2025; 15(7):936. https://doi.org/10.3390/bs15070936

Chicago/Turabian Style

Jiménez-Gonzalo, Lucía, María Márquez-González, Carlos Vara-García, Rosa Romero-Moreno, Javier Olazarán, Roland von Känel, Brent T. Mausbach, and Andrés Losada-Baltar. 2025. "Bidirectional Relationship Between Insomnia and Depressive Symptoms in Family Caregivers of People with Dementia: A Longitudinal Study" Behavioral Sciences 15, no. 7: 936. https://doi.org/10.3390/bs15070936

APA Style

Jiménez-Gonzalo, L., Márquez-González, M., Vara-García, C., Romero-Moreno, R., Olazarán, J., von Känel, R., Mausbach, B. T., & Losada-Baltar, A. (2025). Bidirectional Relationship Between Insomnia and Depressive Symptoms in Family Caregivers of People with Dementia: A Longitudinal Study. Behavioral Sciences, 15(7), 936. https://doi.org/10.3390/bs15070936

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