Poor sleep quality and associated factors among hypertensive follow-up patients in Southwest Ethiopia

Abstract

Poor sleep quality is increasingly recognized as a public health concern due to its strong association with hypertension and cardiovascular morbidity. Although the burden of sleep disorders is rising globally, evidence from low-income settings such as Ethiopia remains limited. This study aimed to assess poor sleep quality and its associated factors among hypertensive patients attending follow-up care in Southwest Ethiopia. An institution-based cross-sectional study was conducted from June to July 2024 among 364 systematically selected hypertensive patients. Data were collected using interviewer-administered questionnaires. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, with scores ≥ 5 indicating poor sleep. Substance use was measured using the Fagerström Test for Nicotine Dependence, Severity of Dependence Scale, and CAGE questionnaire. Bivariate and multivariable logistic regression analyses were performed, and variables with p < 0.05 were considered statistically significant. The prevalence of poor sleep quality was 54.4% (95% CI: 48.6–59.0). Factors significantly associated with poor sleep included age 40–59 years (AOR = 2.61; 95% CI: 1.48–4.61), age ≥ 60 years (AOR = 2.90; 95% CI: 1.54–5.54), physical inactivity (AOR = 2.19; 95% CI: 1.32–3.65), and diastolic blood pressure stages I (AOR = 4.27; 95% CI: 1.60–11.41) and II (AOR = 5.40; 95% CI: 1.99–14.67). Over half of hypertensive patients had poor sleep quality. Older age, physical inactivity, and higher diastolic blood pressure were key predictors. Integrating sleep-health promotion and lifestyle counseling into hypertension management could improve outcomes in resource-limited settings.