Association between Subjective Sleep Quality, Hypertension, Depression and Body Mass Index in a Nigerian Family Practice Setting

Abstract

Objectives: Poor subjective sleep quality in primary care has not been widely studied in Nigeria; hence this study was aimed to evaluate the subjective sleep quality and to find the association with blood pressure, depression and body mass index.Methodology: Pittsburg Sleep Quality Index (PSQI) questionnaire was administered. Good sleep quality was defined as PSQI less than 5. The level of depression was assessed using the Patient Health Questionnaires (PHQ-9). Results:The sample consisted of 400 subjects in the age group 18-70years. The overall mean age did 48.0 + 13.2 years, with the age group 41-50years constitute 29.5% of the studied subjects. Whilst 240 (60%) had normal blood pressure, 29(7.5%) had stage 1 and 43 (10.8%) had stage 2 hypertension. One hundred and thirty eight (34.5%) had normal weight, while 108 (27.0%) were obese. Overall sleep quality was very good, fairly good, fairly bad, and very bad in, 30.8%, 33.2%, 19.5%, and 16.5% of the respondents respectively. The prevalence of poor sleep quality was 44.0%. There was strong statistical association between poor sleep quality, blood pressure (p-value 0.002), depression (p-value 0.000) and body mass index (p-value 0.05). Conclusion:A substantial proportion of the subjects had poor sleep quality associated with high blood pressure, increased body mass index and depression.

Psychological Distress Induces Poor Sleep Quality: A Cross-Sectional Study of Pharmacy Students in Bandung City, Indonesia

“…Poor sleep quality has been closely related to mood disturbance and a number of risk factors for poor health outcomes [6], including high blood pressure, increased body mass index and depression [7]. Moreover, insomnia, poor sleep quality, and short sleep have been found to be correlated with high stress [8,9].…”

Association of body mass index and gender with sleep quality in medical students: A survey.

“…6 It is closely associated with mood disturbances and risk factor for development of high arterial blood pressure or hypertension (HTN), high body mass index (overweight or obesity) and depression that affects the quality of life (QOL). 7,9,10 The poor sleep quality affects the quality of life including physically and psychologically on the performances of students and exerts several physiological effects like worsening of glucose metabolism by impaired glucose tolerance and insulin sensitivity, increased sympathetic activity, elevated inflammation and imbalance in secretion of ghrelin and leptin, so subsequently affects the appetite and hunger. 19 20 These gender based differences are due to structural differences or body difference or biological differences, circadian rhythm or circadian clock genes, respiratory control, sex hormones or sex steroid hormones, stress response, social behaviors that affects the quality of sleep in male and females.…”

“…Sleep quality is described as good sleep and poor sleep, so good sleep includes not only absence of sleep disturbances like restless leg syndrome or insomnia (difficulty in falling sleep or stay asleep) or obstructive sleep apnea but all the presence of conditions which facilitates the adequate duration of sleep or fall asleep on going to bed or maintenance of sleep continuity without disturbances and after awakening feel refreshed or active 8 , while Poor sleep quality have a serious health issues most likely i-e physical, mental and psychological as well as poor performance during class work or daily day time activities, and risk factors for development of high blood pressure (HTN), increased body mass index (BMI) that ultimately affects the quality of life (QOL). 9,10 Moreover, association or relationship between poor sleep and high body mass index or obesity, may vary according to the gender and race. 11 Overall, estimates of poor sleeping quality (sleeping disturbances/periodic or frequent sleeping problems or excessive sleepiness in daytime) were ranging between 13.8% and 68.6% among college students, that depends upon the protocol used for measurement.…”

Hubungan Antara Kualitas Tidur Dengan Indeks Massa Tubuh Pada Pelajar Sma 4 Di Denpasar Tahun 2015

“…menyatakan bahwa terdapat hubungan bermakna antara kualitas tidur dengan IMT dimana dari 2.803 sampel, didapatkan sampel dengan IMT terbanyak yaitu dari golongan overweight sejumlah 40% dan juga didapatkan sampel dengan IMT golongan obesitas sejumlah 22%. 15 Dari uji statistik, didapatkan nilai p yaitu 0,143 menujukkan bahwa tidak ditemukan adanya hubungan bermakna antara kualitas tidur dan IMT pada pelajar SMAN kolesterol, HDL, trigliserida, eGFR serta ALT memperlihatkan adanya korelasi antara kualitas tidur yang buruk dengan peningkatan IMT. Jumlah sampel yang terlalu sedikit pada penelitian ini juga menyebabkan tidak meratanya sampel berdasarkan klasifikasi BMI.…”