Sleep quality and associated factors in older outpatients with hypertension in Vietnam: A cross-sectional study
Abstract
Background & Aim: Sleep plays a crucial role in controlling blood pressure. Older adults commonly suffer from poor sleep quality which results in several negative health outcomes, such as cognitive impairment, depression, and increased risk of falling. However, limited research exists on sleep quality in older Vietnamese adults. This study aimed to investigate sleep quality and its associated factors in older adults with hypertension in Central Vietnam.
Methods & Materials: A cross-sectional study was conducted at a tertiary hospital in Central Vietnam with 235 outpatients who were aged 60 years or older, diagnosed with hypertension, and without cognitive impairment. The Pittsburgh Sleep Quality Index was utilized to assess the participants' sleep quality. Multiple binary logistic regression was computed to identify factors associated with sleep quality with a P value less than 0.05.
Results: The mean sleep quality score was 8.2 (±3.9), with 71.9% of participants reporting poor sleep quality. Participants with a high school education or less were more likely to report poor sleep quality than those with higher education (OR= 1.91; 95% CI: 1.05 - 3.46; p= 0.034). Additionally, the presence of musculoskeletal disease increased the risk of poor sleep quality (OR= 2.26; 95% CI: 1.04 - 4.87; p= 0.038).
Conclusion: The majority of participants suffered from poor sleep quality, which was strongly associated with educational level and the presence of musculoskeletal diseases. Strategies for early detection, prevention, and treatment of poor sleep quality are essential for improving health outcomes in this population.
1. World Health Organization. Global report on hypertension: The race against a silent killer. Geneva: World Health Organization; 2023:1-276.
2. Kario K, Okura A, Hoshide S, Mogi M. The WHO Global Report 2023 on hypertension warning the emerging hypertension burden in the globe and its treatment strategy. Hypertension Research. 2024 May;47(5):1099-102. doi: 10.1038/s41440-024-01622-w.
3. Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, Williams KA. Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology. 2020 Feb;43(2):99-107. doi: 10.1002/clc.23303.
4. Egan BM, Mattix-Kramer HJ, Basile JN, Sutherland SE. Managing Hypertension in Older Adults. Current Hypertension Reports. 2024 Apr;26(4):157-67. doi: 10.1007/s11906-023-01289-7.
5. Bui Van N, Vo Hoang L, Bui Van T, Anh HN, Minh HT, Do Nam K, Tri TN, Show PL, Nga VT, Thimiri Govinda Raj DB, Chu DT. Prevalence and risk factors of hypertension in the Vietnamese elderly. High Blood Pressure & Cardiovascular Prevention. 2019 Jun 1;26:239-46. doi: 10.1007/s40292-019-00314-8.
6. Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of hypertension. 2024 Jan 1;42(1):23-49. doi: 10.1097/HJH.0000000000003563.
7. Bock JM, Vungarala S, Covassin N, Somers VK. Sleep duration and hypertension: epidemiological evidence and underlying mechanisms. American Journal of Hypertension. 2022 Jan 1;35(1):3-11. doi: 10.1093/ajh/hpab146.
8. Li C, Shang S. Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014). International Journal of Environmental Research and Public Health. 2021 Jul 25;18(15):7867. doi: 10.3390/ijerph18157867.
9. Oseni TIA, Udonwa NE, Oku AO, Makinde MT, Archibong F. Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: A cross-sectional study. BMJ Open. 2024;14(3):e079774. doi: 10.1136/bmjopen-2023-079774.
10. Iwamoto Y, Fujino N, Furuno T, Fujimoto Y. Development of a self-evaluation scale of nursing practices for improving sleep quality among dementia patients taking sleeping pills. Nursing Practice Today. 2023; 10(1):32-43.
11. Li L, Li L, Chai JX, Xiao L, Ng CH, Ungvari GS, Xiang YT. Prevalence of poor sleep quality in patients with hypertension in china: a meta-analysis of comparative studies and epidemiological surveys. Frontiers in Psychiatry. 2020 Jun 30;11:591. doi: 10.3389/fpsyt.2020.00591.
12. Handayani W, Lukman M, Sari CW. Quality of sleep among elderly with hypertension at werdha institusion in West Java Province. Journal of Nursing Science Update (JNSU). 2021 May 31;9(1):133-42. doi: 10.21776/ub.jik.2021.009.01.17
13. Gou F, Zhong X, Jiao H. Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China. Medicine. 2023 Jun 2;102(22):e33926. doi:10.1097/MD.0000000000033926.
14. Ayanaw T, Temesgen M, Azagew AW, Ferede YM. Sleep quality and associated factors among adult hypertensive patients attending a chronic follow-up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia. PLoS One. 2022;17(7):e0271072. doi:10.1371/journal.pone.0271072.
15. General Statistics Office of Viet Nam. The population and housing census 2019: Population aging and older persons in Vietnam. 2021. Available from:https://vietnam.unfpa.org/sites/default/files/pub-pdf/ageing_report_from_census_2019_eng_final27082021.pdf.
16. Diu TT, Anh PTN, Hang NT. Investigation of sleep quality by Pittsburgh score (Pittsburgh Sleep Quality Index - PSQI) on hypertensive patients at Thong Nhat Dong Nai general hospital. Vietnam Journal of Community Medicine. 2024;65(1):31-8. doi: 10.52163/yhc.v65iCD1.964
17. Nguyen TH, Do TT, Tran TH. Several factors related to sleep disorders in elderly patients with hypertension treated at National Geriatric Hospital. Journal of Military Pharmaco-Medicine. 2023;48(7):33-43. doi: 10.56535/jmpm.v48i7.389
18. Tran TH, Do TT, Nguyen TH, Nguyen TH. Features of sleep quality in elderly patients with hypertension treated at National Geriatric Hospital. Vietnam Medical Journal. 2023;529(1B). doi:10.51298/vmj.v529i1B.6357
19. Brooke P, Bullock R. Validation of a 6-Item Cognitive Impairment Test with a view to primary care usage. International Journal of Geriatric Psychiatry. 1999;14:936-40.
20. Thuy LT, Monkong S, Pookboonmee R, Leelacharas S, Viwatwongkasem C. Factors explaining medication adherence of older adults with hypertension: A cross-sectional study. Pacific Rim International Journal of Nursing Research. 2020;24(3):306-20. https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/209539
21. Tuan NV, Thang N, Tung VS, Chi LL, Xuyen NTK, Nghi DHP, et al. Clinical characteristics of sleep quality in elderly patients with hypertension. Journal of Medical Research. 2021;145(9):45-54. doi: 10.52852/tcncyh.v145i9.257.
22. Weir CB, Arif J. BMI classification percentile and cut-off points. Florida: StatPearls Publishing; 2021:1-5.
23. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989 May 1;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
24. To MN, Nguyen DN. Validity of the Vietnamese version of the Pittsburgh Sleep Quality Index. Vietnam Journal of Preventive Medicine. 2017;27(4):50-6.
25. Than TNH, Le TVM, Nguyen TTT, Nguyen TV, Nguyen TC, Nguyen TV. Poor sleep quality and associated factors among community-dwelling older adults in Vietnam. Aging Medicine and Healthcare. 2023;14(3):130-37. doi:10.33879/AMH.143.2022.02016.
26. Wu W, Wang W, Dong Z, Xie Y, Gu Y, Zhang Y, et al. Sleep quality and its associated factors among low-income adults in a rural area of China: A population-based study. International Journal of Environmental Research and Public Health. 2018;15(9):2055. doi: 10.3390/ijerph15092055.
27. Gyeltshen D, Gyaltshen K, Dorji N, Yangdon K, Wangchuk N, Drakpa L. Nurses' napping practices and their effects on sleepiness, fatigue, well-being, and quality of nursing care. Nursing Practice Today. 2023; 10(2):138-46.
28. Vanderlinden J, Boen F, van Uffelen JGZ. Effects of physical activity programs on sleep outcomes in older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity. 2020;17(1):11. doi: 10.1186/s12966-020- 0913-3.
2. Kario K, Okura A, Hoshide S, Mogi M. The WHO Global Report 2023 on hypertension warning the emerging hypertension burden in the globe and its treatment strategy. Hypertension Research. 2024 May;47(5):1099-102. doi: 10.1038/s41440-024-01622-w.
3. Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, Williams KA. Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology. 2020 Feb;43(2):99-107. doi: 10.1002/clc.23303.
4. Egan BM, Mattix-Kramer HJ, Basile JN, Sutherland SE. Managing Hypertension in Older Adults. Current Hypertension Reports. 2024 Apr;26(4):157-67. doi: 10.1007/s11906-023-01289-7.
5. Bui Van N, Vo Hoang L, Bui Van T, Anh HN, Minh HT, Do Nam K, Tri TN, Show PL, Nga VT, Thimiri Govinda Raj DB, Chu DT. Prevalence and risk factors of hypertension in the Vietnamese elderly. High Blood Pressure & Cardiovascular Prevention. 2019 Jun 1;26:239-46. doi: 10.1007/s40292-019-00314-8.
6. Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of hypertension. 2024 Jan 1;42(1):23-49. doi: 10.1097/HJH.0000000000003563.
7. Bock JM, Vungarala S, Covassin N, Somers VK. Sleep duration and hypertension: epidemiological evidence and underlying mechanisms. American Journal of Hypertension. 2022 Jan 1;35(1):3-11. doi: 10.1093/ajh/hpab146.
8. Li C, Shang S. Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014). International Journal of Environmental Research and Public Health. 2021 Jul 25;18(15):7867. doi: 10.3390/ijerph18157867.
9. Oseni TIA, Udonwa NE, Oku AO, Makinde MT, Archibong F. Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: A cross-sectional study. BMJ Open. 2024;14(3):e079774. doi: 10.1136/bmjopen-2023-079774.
10. Iwamoto Y, Fujino N, Furuno T, Fujimoto Y. Development of a self-evaluation scale of nursing practices for improving sleep quality among dementia patients taking sleeping pills. Nursing Practice Today. 2023; 10(1):32-43.
11. Li L, Li L, Chai JX, Xiao L, Ng CH, Ungvari GS, Xiang YT. Prevalence of poor sleep quality in patients with hypertension in china: a meta-analysis of comparative studies and epidemiological surveys. Frontiers in Psychiatry. 2020 Jun 30;11:591. doi: 10.3389/fpsyt.2020.00591.
12. Handayani W, Lukman M, Sari CW. Quality of sleep among elderly with hypertension at werdha institusion in West Java Province. Journal of Nursing Science Update (JNSU). 2021 May 31;9(1):133-42. doi: 10.21776/ub.jik.2021.009.01.17
13. Gou F, Zhong X, Jiao H. Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China. Medicine. 2023 Jun 2;102(22):e33926. doi:10.1097/MD.0000000000033926.
14. Ayanaw T, Temesgen M, Azagew AW, Ferede YM. Sleep quality and associated factors among adult hypertensive patients attending a chronic follow-up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia. PLoS One. 2022;17(7):e0271072. doi:10.1371/journal.pone.0271072.
15. General Statistics Office of Viet Nam. The population and housing census 2019: Population aging and older persons in Vietnam. 2021. Available from:https://vietnam.unfpa.org/sites/default/files/pub-pdf/ageing_report_from_census_2019_eng_final27082021.pdf.
16. Diu TT, Anh PTN, Hang NT. Investigation of sleep quality by Pittsburgh score (Pittsburgh Sleep Quality Index - PSQI) on hypertensive patients at Thong Nhat Dong Nai general hospital. Vietnam Journal of Community Medicine. 2024;65(1):31-8. doi: 10.52163/yhc.v65iCD1.964
17. Nguyen TH, Do TT, Tran TH. Several factors related to sleep disorders in elderly patients with hypertension treated at National Geriatric Hospital. Journal of Military Pharmaco-Medicine. 2023;48(7):33-43. doi: 10.56535/jmpm.v48i7.389
18. Tran TH, Do TT, Nguyen TH, Nguyen TH. Features of sleep quality in elderly patients with hypertension treated at National Geriatric Hospital. Vietnam Medical Journal. 2023;529(1B). doi:10.51298/vmj.v529i1B.6357
19. Brooke P, Bullock R. Validation of a 6-Item Cognitive Impairment Test with a view to primary care usage. International Journal of Geriatric Psychiatry. 1999;14:936-40.
20. Thuy LT, Monkong S, Pookboonmee R, Leelacharas S, Viwatwongkasem C. Factors explaining medication adherence of older adults with hypertension: A cross-sectional study. Pacific Rim International Journal of Nursing Research. 2020;24(3):306-20. https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/209539
21. Tuan NV, Thang N, Tung VS, Chi LL, Xuyen NTK, Nghi DHP, et al. Clinical characteristics of sleep quality in elderly patients with hypertension. Journal of Medical Research. 2021;145(9):45-54. doi: 10.52852/tcncyh.v145i9.257.
22. Weir CB, Arif J. BMI classification percentile and cut-off points. Florida: StatPearls Publishing; 2021:1-5.
23. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989 May 1;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
24. To MN, Nguyen DN. Validity of the Vietnamese version of the Pittsburgh Sleep Quality Index. Vietnam Journal of Preventive Medicine. 2017;27(4):50-6.
25. Than TNH, Le TVM, Nguyen TTT, Nguyen TV, Nguyen TC, Nguyen TV. Poor sleep quality and associated factors among community-dwelling older adults in Vietnam. Aging Medicine and Healthcare. 2023;14(3):130-37. doi:10.33879/AMH.143.2022.02016.
26. Wu W, Wang W, Dong Z, Xie Y, Gu Y, Zhang Y, et al. Sleep quality and its associated factors among low-income adults in a rural area of China: A population-based study. International Journal of Environmental Research and Public Health. 2018;15(9):2055. doi: 10.3390/ijerph15092055.
27. Gyeltshen D, Gyaltshen K, Dorji N, Yangdon K, Wangchuk N, Drakpa L. Nurses' napping practices and their effects on sleepiness, fatigue, well-being, and quality of nursing care. Nursing Practice Today. 2023; 10(2):138-46.
28. Vanderlinden J, Boen F, van Uffelen JGZ. Effects of physical activity programs on sleep outcomes in older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity. 2020;17(1):11. doi: 10.1186/s12966-020- 0913-3.
| Files | ||
| Issue | Vol 11 No 4 (2024): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v11i4.16815 | |
| Keywords | ||
| sleep quality; Pittsburgh Sleep Quality Index; older adults; hypertension | ||
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How to Cite
1.
Tham L, Thuy L. Sleep quality and associated factors in older outpatients with hypertension in Vietnam: A cross-sectional study. NPT. 2024;11(4):361-368.
