Abstract
The wellbeing of caregivers has been the subject of increasing focus in clinical and epidemiological research, predominantly in the UK and US context. One important health area in caregiving that is still comparatively under-researched is sleep poverty, particularly in a cross-cultural perspective. This qualitative study, located in Italy, explores sleep poverty in midlife and older women, taking a narrative life course approach and a grounded theory methodology. Italy has higher care demands than most EU countries, with the highest rates of an ageing population, deficiencies in welfare services’ provision for child and elderly care, strong gender inequalities and social pressure on women to provide informal care. Indepth interviews were conducted with 65 women aged 40-80 living in the Mantua area of Northern Italy. The data showed that caregiving at night triggers a fragmented and alert sleep, which impacts on fatigue and daytime performance. In particular, long-term care for relatives with degenerative, acute and chronic illnesses, such as cancer and dementia, results in a protracted disruption of sleep patterns that can become chronic over time, and degenerate into recurrent bouts of wakefulness, altered circadian rhythms, and insomnia. Symptoms were reported to persist not only during the period of care giving but also to last long term, for months to years after caregiving ceased, with implications for physical and psychological wellbeing, and overall quality of life. This Italian study contributes evidence on how family structure, gender role expectations and insufficient state-provided support for caregiving amplify the impact of women’s caring roles on their sleep disruption at different points in their life course. Inadequate welfare provision increases Italian women's unpaid domestic caring work resulting in adverse effects on sleep quality and their overall well being. The thesis discusses the value of qualitative methods for research on women’s health. Previous research has underestimated the burdens resulting from carework, particularly its lifelong, continuous and boundary-ambiguous character, which involves ‘emotional labour’ alongside physical tending. A carer-centred and gender sensitive approach should inform research and policy making, in order to provide a more nuanced and comprehensive understanding of sleep poverty, taking fully into account unpaid home labour, gender dynamics, intergenerational and social determinants and potential health risks for women in the most vulnerable social strata.