Prevalence and factors associated with poor sleep quality among patients with hypertension in a primary care clinic: A cross-sectional study

Abstract

Introduction: International research has consistently shown that individuals with hypertension experience significantly impaired sleep quality, but there is a lack of study in this field in Malaysia. This study aimed to assess the prevalence and associated factors of poor sleep quality among patients with hypertension in a primary care clinic in Malaysia. Methods: A cross-sectional study was conducted among patients with hypertension aged 18 years and above in a public health clinic from December 2023 to February 2024. Systematic random sampling was used to recruit participants. Sociodemographic data and relevant information were obtained using the Pittsburgh Sleep Quality Index; Depression, Anxiety and Stress Scale-21; and STOP-BANG questionnaire. The Statistical Package for the Social Sciences version 27 was used to conduct multiple logistic regression analysis of the determinants of poor sleep quality. Results: A total of 335 participants were recruited, yielding a 98.2% response rate. The mean participant age was 58 years, and 63% were women. The prevalence of poor sleep quality was 87.2%. Multiple logistic regression showed that anxiety symptoms (odds ratio [OR]=12.279, 95% confidence interval [CI]=1.573–95.883, P=0.017), low monthly household income (OR=3.573, 95% CI=1.627–7.847, P=0.002), lack of exercise (OR=2.530, 95% CI=1.108–5.775, P=0.028) and risk of obstructive sleep apnoea (OR=2.521, 95% CI=1.176–5.402, P=0.017) were associated with poor sleep quality. Conclusion: Poor sleep quality is prevalent among patients with hypertension and is associated with adverse cardiovascular events. Increased awareness among primary care physicians would allow early identification of patients at risk for early intervention.