OBJECTIVES:  We examined the longitudinal effects of caregiving with other relevant predictors on metabolic parameters in a cohort of Alzheimer caregivers with controls. METHODS:  A sample of 109 spousal Alzheimer caregivers and 53 non-caregiving age-and gender-matched controls were recruited for this community-based longitudinal study with annual assessments for up to four years. Among the participants, a total of 91 subjects (72 caregivers and 19 non-caregiving controls) with a baseline PSQI > 5, were included for the analysis. RESULTS:  Metabolic profiles including body mass index (BMI), blood pressure, lipids profiles, and glucose were measured repeatedly during annual assessment. Mixed linear models with time effects for covariates known to affect metabolic parameters were used to evaluate their changes. Multivariate-adjusted metabolic parameters did not significantly differ between caregivers and non-caregivers over time except for systolic blood pressure. For male, HDL levels increased with non-caregiving status (p = 0.02), higher role overload (p = 0.02), and baseline high HDL status (p < 0.001). For female, HDL levels increased with time (p = 0.02) and decreased with increased role overload (p = 0.02). CONCLUSIONS:  Among poor sleepers (PSQI > 5), Alzheimer caregivers and non-caregiving controls had similar metabolic profiles. Role overload, caregiving status, and time had different effects on HDL levels on male and female.