Date of Award

5-7-2026

Degree Type

Thesis

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Dr. Julie Blaskewicz Boron

Abstract

Long-distance caregiving is an increasingly common yet understudied form of family care, particularly among immigrant communities whose cultural expectations of flial responsibility remain strong despite geographic separation. Among South Asian caregivers of older adults, caregiving across borders is shaped by powerful norms of duty, emotional endurance, and family obligation, creating distinctive patterns of stress that may profoundly afect health. One of the most consequential but underexamined outcomes of this caregiving context is sleep. This mixed-methods dissertation examined the physical, environmental, and psychological determinants of sleep among long-distance South Asian caregivers of older adults living in the United States. Guided by the Sociocultural Stress and Coping Model, this dissertation integrated quantitative survey data from 78 caregivers with qualitative focus group narratives to understand how emotional distress, physical activity, and environmental conditions shape sleep within a culturally specifc caregiving context. Chapter 2 examined associations among depressive symptoms, physical activity, and sleep. Chapter 3 investigated home and neighborhood environmental conditions, including cleanliness, noise, and walkability. Chapter 4 focused on caregiving-related stressors, emotional distress, and caregiving uncertainty as predictors of sleep. Across all three studies, emotional distress, particularly depressive symptoms and care-giving uncertainty emerged as the strongest and most consistent predictors of reduced sleep. Environmental support, including whole-home cleanliness and neighborhood walkability, were associated with longer sleep, while physical activity functioned as a coping strategy supporting emotional regulation. Qualitative fndings revealed how cultural values of flial duty, emotional restraint, and moral responsibility intensifed nighttime rumination and sleep disruption, while walking, yoga, and orderly living environments served as culturally embedded strategies for restoring emotional balance. These fndings demonstrate that sleep among South Asian long-distance caregivers is shaped less by caregiving workload than by culturally mediated emotional and contextual stress. By integrating psychological, behavioral, and environmental pathways within a sociocultural framework, this dissertation advances understanding of caregiver sleep and identifes culturally responsive targets for intervention and community-based supports tailored to long-distance caregivers.

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