Alzheimer's disease and related dementias (hereafter dementia) have been increasing in older adults and are predicted to increase from 6.7 million in 2023 to 12.7 million by 2050 in the United States.1 In 2022, over 11 million family members provided unpaid care to persons with dementia (PWD) with progressive decline in cognitive functioning and difficult behavioral problems.1

Sleep disturbances are one of the foremost health problems in PWD and family caregivers living in the same household. Approximately 60–70% of PWD have been found to suffer from sleep disturbance, including difficulty falling or staying asleep as well as excessive daytime sleepiness or fatigue.1,2 Sleep disturbances may worsen the behavioral problems and cognitive impairments of PWD, leading to nighttime wandering, agitation, and increased memory loss.2, 3, 4 Family caregivers are also more likely to experience nonrestorative sleep due to PWD's nighttime needs.5,6 Recent literature indicates that family caregivers of PWD lost an average of 2.4 - 3.5 hours of sleep a week compared to age-matched non-caregivers due to complex caregiving burdens.5,6 Sleep disturbances of caregivers are significantly associated with caregivers’ stress, burden, and depression, which negatively affect their caregiving capacity and hasten dementia patients’ transitions to long-term care facilities.7, 8, 9 Therefore, there may be interrelated effects of sleep disturbances between PWD and caregivers either directly or indirectly as an interactional unit.

Korean Americans are individuals who are of Korean descent and immigrated to the United States or are born in the United States with parents from Korea. Although the Korean American population has been growing in the U.S., the group remains as one of the understudied ethnic minorities.10,11 Estimates suggest sleep problems affect approximately 80% of older Korean immigrants in the U.S.11, 12, 13, 14 However, little is known about the associated phenomenon of sleep disturbances between Korean immigrants with dementia and their family members, especially PWD-caregiver dyads. A dyadic-based approach includes the PWD-caregiver pair, and focuses on not only individuals or the family as a whole but the interrelationship of PWD and the caregiver as paired units.15,16 Findings from research using dyadic approaches show that dyadic perspectives were important in understanding dementia caregiving in the context of human illness by considering both members of the adult patient–care partner dyad.17,18

The purpose of this study was to understand the lived experience of dyads’ sleep disturbances and perceived sleep interrelationship using a PWD-caregiver dyadic approach among Korean American PWD and caregivers.