Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China

Nocturia, Sleep Quality, and Mortality: A Systematic Review and Meta-Analysis

PURPOSE

Nocturia is increasingly recognized as a significant factor influencing sleep quality and potentially linked to increased mortality risk. This meta-analysis aimed to systematically review and synthesize existing research investigating the relationship between nocturia, sleep quality, and mortality, in a single framework.

MATERIALS AND METHODS

A comprehensive systematic search across PubMed, Embase, and the Cochrane Library was conducted from the inception of each database until April 2, 2024, yielding studies investigating the methodological qualities and the relationship between nocturia and its impact on mortality and sleep quality. Risk of Bias was assessed using ROBINSE tool and RevMan 5.4 was used to analyze the results.

RESULTS

Of the 1,450 studies subjected to screening, 33 were selected for analysis. Fourteen studies examined the association between nocturia and mortality, and 19 studies investigated impact of nocturia on sleep quality. Significant associations were found between nocturia and both mortality (pooled risk ratio: 1.78, 95% confidence interval [CI]: 1.50-2.10) and poor sleep quality (pooled odds ratio: 3.05, 95% CI: 1.89-4.93). Patients with nocturia demonstrated significantly poorer sleep quality scores compared with controls (pooled standardized mean difference: 1.01, 95% CI: 0.55-1.47).

CONCLUSIONS

This meta-analysis underscores the significance of addressing nocturia as a public health concern owing to its association with poor sleep quality and increased mortality risk. It advocates for comprehensive patient care strategies for addressing nocturia, sleep quality, and mortality.

Sleep quality and hypertension in an indigenous African population: a cross-sectional investigation from the COMBAT-CVDs study

Hypertension is a major risk factor for cardiovascular events worldwide, and little is known about its association with sleep quality (SQ) among Africans. We evaluated the association of SQ with hypertension among adults in Ibadan, Nigeria. In Ibadan and its suburbs, we identified 3635 participants in the door-to-door Community-based Investigation of the Risk Factors for Cardiovascular Diseases (COMBAT-CVDs) study. SQ was self-reported, and SQ scores were classified by the tertile distribution in this sample as good (<9), moderate (10-18), and poor (≥19), and hypertension was defined as one of the following conditions: systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or prior diagnosis by a certified health professional or current use of blood pressure-lowering drugs. Using good SQ as a reference, logistic regression models were used to estimate the multivariable-adjusted odds ratio and 95% confidence interval (CI) for odds of hypertension by tertiles of SQ scores in a two-sided test at p < 0.05. In all, 1182 (32.5%) had poor SQ, 903 (24.8%) had hypertension, and the mean(±SD) age was 35.3 ± 15.2 years in this sample. The multivariable-adjusted odds of hypertension by tertiles of SQ scores (using good SQ as reference) were OR: 1.13 (95% CI: 0.92, 1.38) for moderate SQ, and OR: 1.29 (95% CI: 1.05, 1.59) for poor SQ; P for trend = 0.06 after adjusting for relevant covariates. Poor SQ is associated with higher odds of hypertension in this sample. The imperative of culturally sensitive interventions to improve SQ would be promising in managing poor sleep-associated hypertension burden in this population.

Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study

OBJECTIVES

Restorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between sleep quality and blood pressure control among hypertensive patients in Southern Nigeria.

DESIGN

Cross-sectional study.

SETTING

A rural tertiary hospital in Southern Nigeria, April to June 2023.

PARTICIPANTS

250 systematically selected hypertensive adults. Participants completed a validated semistructured interviewer-administered questionnaire to assess their sleep patterns, including sleep duration, self-reported trouble sleeping and a history of clinical diagnosis of sleep disorders. Sleep patterns were categorised as restorative (healthy) or non-restorative (unhealthy). The blood pressure of respondents was checked and categorised as controlled (<140/90 mm Hg) or uncontrolled (≥140/90 mm Hg). Data were analysed descriptively using SPSS V.24.0 OUTCOME MEASURES: Quality of sleep and blood pressure control.

RESULTS

Respondents had a mean age of 51.5±10.0 years, with the majority being female (156, 62.4%), married (135, 54.0%) and belonging to the Esan tribe (125, 50.0%). The prevalence of restorative sleep was 36%, while the blood pressure control rate was 23.6%. An association was found between restorative sleep and blood pressure control (adjusted OR =4.38; 95% CI=2.37-8.10; p<0.0001). Respondents aged ≥60 years had 3.5 times higher odds of experiencing non-restorative sleep than those aged ≤40 years (aOR=3.46; 95% CI=1.37-8.74; p=0.009).

CONCLUSION

The study found an association between poor quality sleep and poor blood pressure control. Incorporating sleep assessments and interventions into comprehensive hypertension management strategies could be explored as a possible approach to improve sleep quality and enhance blood pressure control.

TRIAL REGISTRATION NUMBER

PACTR202301917477205.