Restorative free time and psychological distress among employed family caregivers of individuals with cognitive impairment: a cross-sectional study

Background Employed family caregivers of individuals with cognitive impairment often need to balance work responsibilities, caregiving tasks, and their own daily lives. Although caregiving burden is commonly discussed in terms of time spent caregiving, less attention has been paid to whether caregivers have enough time to recover from these demands. Objective This study examined the associations of daily time-use factors, including restorative free time, sleep duration, working hours, and caregiving duration, with psychological distress among employed family caregivers of individuals with cognitive impairment. Methods A cross-sectional study was conducted as part of the Sustaining for Aging Dementia Relatives Support and Employment project in Japan. Questionnaires were distributed to family caregivers, and data from 210 employed caregivers were analyzed. Psychological distress was assessed using the Kessler 6 scale. Modified Poisson regression with robust variance estimation was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the associations between daily time use and psychological distress. In supplementary analyses, logistic regression was used to explore factors associated with severely limited restorative free time (<1 h/day), including care recipient characteristics such as functional status and long-term care certification. Results Caregivers with less than 1 h of restorative free time per day had a significantly higher prevalence of psychological distress than those with 3 h or more. Short sleep duration (<6 h/day) was also associated with a higher prevalence of psychological distress, whereas working hours and caregiving duration were not significantly associated with psychological distress after multivariable adjustment. Conclusion Severely limited restorative free time and short sleep duration were associated with a higher prevalence of psychological distress among employed family caregivers. Limited restorative free time may therefore serve as a potential marker of psychological distress in this population. However, the cross-sectional design does not establish the temporal or causal direction of these associations.