A growing number of people are finding themselves in the role of being a primary caregiver to older parents, partners or friends. For some the caregiving demands may last for a few days, several weeks or even for years. Like taking on any new role, shifting into the caregiver job can be difficult and stressful in ways that are difficult to anticipate. Along with the stresses inherent in these new life complications, primary caregivers can find their own health becoming compromised.

QUESTION: What types of lifestyle factors can change in the life of a new caregiver?

ANSWER: Along with the increased psychological stress caused by a new set of uncertainties, it is common for caregivers to get significantly less good-quality sleep for many reasons. This, of course, can lead to ongoing fatigue, making it challenging to maintain good nutrition and exercise habits. Consequently, a vicious cycle can develop in which declining health makes it more challenging to do what is needed to maintain health.

Frequently, caregivers need to change their usual sleep patterns. This is especially the case when caring for an older individual who falls into a condition called sundown syndrome (also known as sundowning or sunsetting). This syndrome gets its name from the tendency of an older person to become anxious, confused, agitated and even very scared after the sun goes down. Sundowners can be up much of the night and sleep only in short bouts. This, of course, keeps the caregivers from getting an adequate amount of good, quality sleep as well.

Q: What are the potential health risks of caregiving?

A: Research indicates that caregivers are at high risk of developing depression, possibly due to the loss of personal time and the challenges inherent in juggling family and work along with caregiving responsibilities. It also is now known that chronic sleep deprivation can trigger many health problems such as fibromyalgia (characterized by joint pains and muscle tenderness), hypertension, silent strokes, cancer, diabetes and impaired immune function.

Possibly more bothersome on a daily basis is the decreased ability to concentrate, to make decisions, to learn, to drive safely or even form new memories. All of these brain functions put caregivers and those that they are caring for at risk.

Another behavior that is changed is food preferences. Studies have shown that lack of sleep increases the desire to eat, even when a person has had adequate calories. This may explain the weight gain commonly seen in caregivers. Other research shows that even in healthy people, restricted sleep leads to increased food consumption and an increased desire for sweet and salty foods.

Q: What can a person do to prevent the potentially negative ramifications of caregiving?

A: Take advantage of community resources. A good starting place is the University of Hawaii Center on Aging (www.hawaii.edu/aging). Programs for the elderly are increasingly becoming aware of the need to support caregiver needs. If you are (or may become) a caregiver, explore these resources before you need them so you know where to go when you need help. Plan ahead with other family members to answer the "what-if questions" before decisions are needed. Foreknowledge of potential challenges that may be encountered along with an awareness of community and family resources can help to make the caregiving role the positive experience that it ideally can be.

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Joannie Dobbs, Ph.D., C.N.S., and Alan Titchenal, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa. Dobbs also works with University Health Services.