The Burden of Care: A Prospective Observational Study on Sleep Disturbances among Caregivers of Persons with Chronic Mental Illness

Abstract Background: Caregivers of individuals with chronic mental illness often experience prolonged emotional, psychological, and physical strain, which can lead to significant and persistent sleep disturbances. Poor sleep adversely affects caregivers’ health and caregiving performance, yet it remains an under-addressed aspect in mental health care services. Objective: To examine changes in the sleep quality of caregivers of patients with chronic mental illness, without any intervention, over a 1-month follow-up period, and to explore the influence of demographic and caregiving factors using the Pittsburgh sleep quality index (PSQI). Materials and Methods: This prospective observational study included 100 adult primary caregivers recruited through convenience sampling from a tertiary care mental health facility in India. Demographic data and PSQI scores were collected at baseline and after a 1-month follow-up. No intervention was provided during the study period. Data were analyzed using the Wilcoxon signed-rank test in IBM Statistical Package for the Social Sciences version 26.0. Results: At baseline, 68% of caregivers reported poor sleep quality (PSQI > 5), decreasing slightly to 66% at follow-up. No statistically significant change was found in global PSQI scores ( Z = −0.515, P = 0.607). Poor sleep was more prevalent among female, middle-aged, unemployed caregivers and those caring for highly dependent patients. Sleep duration and habitual sleep efficiency were the most affected PSQI components. Conclusion: In the absence of intervention, sleep quality among caregivers of individuals with chronic mental illness remains largely unchanged over a 1-month period. Early identification and tailored psychosocial strategies are essential to mitigate caregiver burden and improve overall health care outcomes.