ความชุกและความสัมพันธ์ระหว่างคุณภาพการนอนหลับกับความดันโลหิตสูงในผู้ใหญ่ที่มารับบริการที่แผนกผู้ป่วยนอก โรงพยาบาลพระมงกุฎเกล้า

Cherdpong Wongwaipanich; Kasidid Lawongsa

Authors

Cherdpong Wongwaipanich Family medicine, Outpatients department, Phramongkutklao Hospital
Kasidid Lawongsa Family medicine, Outpatients department, Phramongkutklao Hospital https://orcid.org/0009-0006-8956-6378

Keywords:

Hypertension, Sleep Quality, Pittsburgh Sleep Quality Index (PSQI), Outpatients, Cross-Sectional Study

Abstract

This study is an analytic cross-sectional study aimed at exploring the relationship between sleep quality and hypertension among outpatients aged 35–60 years attending Phramongkutklao Hospital. Participants (n = 246) were selected based on predefined eligibility criteria using convenience sampling, including the ability to communicate clearly in Thai and willingness to participate in the study. Data were collected using a structured questionnaire that included demographic and health-related information and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Data analysis included descriptive statistics such as mean, standard deviation, frequency, and percentage were used to summarize the participants' demographic and clinical characteristics, Chi-square tests, and multiple logistic regression to assess the relationship between sleep quality and hypertension.

The results showed that out of 246 participants, 160 (65.0%) had poor sleep quality, while 86 (35.0%) had good sleep quality. Participants with poor sleep quality had a significantly higher likelihood of developing hypertension (AOR: 7.54, 95% CI: 3.33–17.06, p < 0.001). Additionally, other risk factors for hypertension included being older than 50 years (Adjusted OR: 3.39, p = 0.001), alcohol consumption (Adjusted OR: 3.93, p < 0.001), and a family history of hypertension (Adjusted OR: 5.47, p < 0.001). This study highlights the critical role of poor sleep quality and other associated factors in the risk of hypertension. Incorporating sleep quality assessment and appropriate interventions into routine clinical care can help prevent and reduce the risk of complications in hypertensive patients.

References

Bjoroy, I., Jørgensen, V. A., Pallesen, S., & Bjorvatn, B. (2020). The Prevalence of Insomnia Subtypes in Relation to Demographic Characteristics, Anxiety, Depression, Alcohol Consumption and Use of Hypnotics. Frontiers in Psychology, 24(11). https://doi.org/10.3389/fpsyg.2020.00527

Chen, S., Song, X., Shi, H., Li, J., Ma, S., Chen, L., Lu, Y., Hong, C., Zhu, H., Sun, H., & Zhang, M. (2022). Association Between Sleep Quality and Hypertension in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort. Nature and Science of Sleep, 28(14), 2097–2105. https://doi.org/10.2147/NSS.S388535

Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., & Roccella, E. J. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA, 289(19), 2560–2572. https://doi.org/10.1001/jama.289.19.2560

CHOWDHURY, A. I., GHOSH, S., HASAN, MD. F., KHANDAKAR, K. A. S., & AZAD, F. (2021). Prevalence of insomnia among university students in South Asian Region: a systematic review of studies. Journal of Preventive Medicine and Hygiene, 61(4), E525–E529. https://doi.org/10.15167/2421-4248/jpmh2020.61.4.1634

Gangwisch, J. E. (2014). A Review of Evidence for the Link Between Sleep Duration and Hypertension. American Journal of Hypertension, 27(10), 1235–1242. https://doi.org/10.1093/ajh/hpu071

Grandner, M. A., & Drummond, S. P. A. (2007). Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Medicine Reviews, 11(5), 341–360. https://doi.org/10.1016/j.smrv.2007.03.010

Kim, J., & Jo, I. (2010). Age-Dependent Association Between Sleep Duration and Hypertension in the Adult Korean Population. American Journal of Hypertension, 23(12), 1286–1291. https://doi.org/10.1038/ajh.2010.166

Laugsand, L. E., Strand, L. B., Platou, C., Vatten, L. J., & Janszky, I. (2013). Insomnia and the risk of incident heart failure: a population study. European Heart Journal, 35(21), 1382–1393. https://doi.org/10.1093/eurheartj/eht019

Li, L., Li, L., Chai, J.-X., Xiao, L., Ng, C. H., Ungvari, G. S., & Xiang, Y.-T. (2020). Prevalence of Poor Sleep Quality in Patients With Hypertension in China: A Meta-analysis of Comparative Studies and Epidemiological Surveys. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00591

Liu, R.-Q., Qian, Z., Trevathan, E., Chang, J.-J., Zelicoff, A., Hao, Y.-T., Lin, S., & Dong, G.-H. (2015). Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: results from a large population-based study. Hypertension Research, 39(1), 54–59. https://doi.org/10.1038/hr.2015.98

Lo, K., Woo, B., Wong, M., & Tam, W. (2018). Subjective sleep quality, blood pressure, and hypertension: a meta-analysis. The Journal of Clinical Hypertension, 20(3), 592–605. https://doi.org/10.1111/jch.13220

Luyster, F. S., Strollo, P. J., Zee, P. C., & Walsh, J. K. (2012). Sleep: A Health Imperative. Sleep, 35(6), 727–734. https://doi.org/10.5665/sleep.1846

Shan, Z., Ma, H., Xie, M., Yan, P., Guo, Y., Bao, W., Rong, Y., Jackson, C. L., Hu, F. B., & Liu, L. (2015). Sleep Duration and Risk of Type 2 Diabetes: A Meta-analysis of Prospective Studies. Diabetes Care, 38(3), 529–537. https://doi.org/10.2337/dc14-2073

Sitasuwan, T., Bussaratid, S., Ruttanaumpawan, P., & Chotinaiwattarakul, W. (2014). Reliability and validity of the Thai version of the Pittsburgh Sleep Quality Index. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 97 Suppl 3, S57-67. https://pubmed.ncbi.nlm.nih.gov/24772581/

Sofi, F., Cesari, F., Casini, A., Macchi, C., Abbate, R., & Gensini, G. F. (2012). Insomnia and risk of cardiovascular disease: a meta-analysis. European Journal of Preventive Cardiology, 21(1), 57–64. https://doi.org/10.1177/2047487312460020

Uchmanowicz, I., Markiewicz, K., Uchmanowicz, B., Kołtuniuk, A., & Rosińczuk, J. (2019). The relationship between sleep disturbances and quality of life in elderly patients with hypertension. Clinical Interventions in Aging, 2019(14), 155–165. https://doi.org/10.2147/cia.s188499

WHO Consultation on Obesity (1999: Geneva, S., & Organization, W. H. (2000). Obesity : preventing and managing the global epidemic : report of a WHO consultation. In apps.who.int. World Health Organization. https://apps.who.int/iris/handle/10665/42330

Wu, H., Qianwen Lv, Zhang, H., Qin, Y., Fang, F., Sun, H., & Wei, Y. (2019). The reduction of apnea–hypopnea duration ameliorates endothelial dysfunction, vascular inflammation, and systemic hypertension in a rat model of obstructive sleep apnea. Sleep & Breathing, 23(4), 1187–1196. https://doi.org/10.1007/s11325-019-01798-3

Zhan, Y., Zhang, F., Lu, L., Wang, J., Sun, Y., Ding, R., Hu, D., & Yu, J. (2014). Prevalence of dyslipidemia and its association with insomnia in a community based population in China. BMC Public Health, 14(1). https://doi.org/10.1186/1471-2458-14-1050