Tonight's Sleep Predicts Tomorrow's Fatigue: A Daily Diary Study of Long-Term Care Employees with Nonwork Caregiving Roles

Background and Objectives: Long-term care employees and employees with nonwork caregiving roles are at high risk for sleep problems and fatigue. Little is known, however, about relationships between sleep and fatigue among long-term care employees who occupy nonwork caregiving roles. This study examined whether longer sleep duration and better sleep quality reduce fatigue occurrence and severity within and between long-term care employees with nonwork caregiving roles, and investigated nonwork caregiving role occupancy as a moderator of these relationships. Research Design and Methods: The sample comprised 166 women working in U.S.-based nursing homes. All women had children aged 9-17 years and some also had nonwork caregiving responsibilities for adult relatives. Sleep (duration and quality) and fatigue (occurrence and severity) were assessed via telephone interviews for eight consecutive evenings. Multilevel modeling was used to examine within-person and between-person associations. Results: At the within-person level, nights characterized by longer-than-usual sleep duration or better-than-usual sleep quality were followed by days with lower odds of reporting fatigue; these same sleep characteristics predicted less severe next-day fatigue. At the between-person level, employees with better average sleep quality, but not longer sleep duration, had lower odds of experiencing fatigue. Relationships between sleep and fatigue were generally similar regardless of nonwork caregiving responsibilities for children or for both children and adults. Discussion and Implications: Findings suggest that tonight's sleep predicts tomorrow's fatigue. Given the serious and wide-ranging consequences of fatigue, sleep constitutes a worthwhile intervention target with potential benefits for employees, care recipients, and organizations.