Caregiving Burden, Sleep Quality, Perceived Stress, and Resting Cardiovascular Indicators Among Family Caregivers of People with Psychotic Disorders in Faisalabad, Pakistan: An Analytical Cross-Sectional Study

Abstract

Background: Family members caring for people with schizophrenia-spectrum disorders often experience considerable psychological and practical strain. Caregiving burden, stress, and sleep problems are frequently reported, but their relationship with resting cardiovascular functioning remains uncertain. This study examined caregiving burden, perceived stress, sleep quality, and resting cardiovascular indicators among family caregivers in Faisalabad, Pakistan. Methods: A cross-sectional analytical study was conducted with 130 unpaid family caregivers of people diagnosed with schizophrenia or schizoaffective disorder. Caregiving burden was assessed using the Zarit Burden Interview (ZBI-22), perceived stress with the Perceived Stress Scale (PSS-10), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured under standardised conditions. Pearson correlations and multivariable linear regression were used to examine associations between the study variables. 

Results: Caregivers reporting greater burden also reported higher perceived stress (r = .407, p < .001) and poorer sleep quality (r = .389, p < .001). In the unadjusted analyses, caregiving burden was also associated with higher SBP, DBP, and resting HR. These relationships became weaker after adjustment for relevant covariates. Following Benjamini–Hochberg false-discovery-rate correction, none of the nine main psychosocial–cardiovascular associations remained statistically significant. The sensitivity analyses showed a broadly similar pattern. Conclusion: The clearest findings concerned the psychological aspects of caregiving: greater burden was related to higher stress and poorer sleep. In contrast, the evidence linking psychosocial factors independently with resting cardiovascular indicators was weak after adjustment and correction for multiple testing. Routine caregiver assessment in psychiatric services may therefore benefit from including stress and sleep alongside caregiving burden.