Caring Inside Out: Interpersonal Emotion Regulation, Sleep, Health, and the Role of Cultural Values among Family Caregivers

Background: Aging societies worldwide, including Hong Kong, face increasing care demands, with family caregivers playing a vital role. Supporting their well-being is therefore increasingly critical. The dual emotional burden of caregiving—regulating one’s own emotions while managing those of care recipients—may contribute to the high prevalence of sleep problems that further undermine health. This study will be the first to examine how family caregivers’ engagement in interpersonal emotion regulation (IER)—specifically, intrinsic IER (managing one’s own emotions through others) and extrinsic IER (helping others manage theirs)—affects sleep and, in turn, physical and psychological well-being. Recognizing that emotion regulation is shaped by cultural values, this study will also leverage Hong Kong’s multicultural context to examine how interdependence (vs. independence), a cultural value that emphasizes social connectedness and harmony, influences caregivers’ intrinsic and extrinsic IER and their implications for sleep and health.This study includes three key research questions:Q1) Are higher levels of intrinsic IER associated with better sleep, and higher levels of extrinsic IER associated with worse sleep?Q2) Do sleep patterns mediate the relationships between intrinsic and extrinsic IER and caregivers’ physical and psychological well-being?Q3) Does interdependence (vs. independence) influence caregivers’ engagement in intrinsic and extrinsic IER, which in turn are linked to sleep and health?Methods: The study will adopt a multimethod, three-part design involving family caregivers in Hong Kong. (1) A cross-sectional survey will measure intrinsic and extrinsic IER, sleep quality, physical and psychological health, and the cultural values of interdependence and independence. (2) A two-week daily diary (i.e., daily surveys) will capture caregivers’ everyday experiences of intrinsic and extrinsic IER, self-reported sleep and health, and objective sleep indicators via actigraphy watches. (3) A two-month follow-up survey will reassess sleep quality, and physical and psychological health.Together, these complementary assessments will provide cross-sectional, daily, and longitudinal perspectives to address the research questions.Expected Deliverables: This project will generate a unique dataset on family caregivers’IER, sleep, and health. The findings will enhance family caregivers’ awareness of how emotion regulation influences sleep and health, and will offer practical guidelines for community organizations and health professionals to strengthen caregiver support.Ultimately, the study will inform culturally sensitive practices and interventions, support policies that sustain family caregiving, and contribute to a healthier aging society in Hong Kong and beyond.