The relationship between sleep disturbances and quality of life in elderly patients with hypertension

Figures & data

Table 1 Sociodemographic and clinical data of persons with and without drowsiness

Features			Drowsiness (N=39)		Lack of drowsiness (N=61)		Total (N=100)		Pa
			N	%	N	%	N	%
Sex
Female			16	41.03	30	49.18	46	46.00	0.554
Male			23	58.97	31	50.82	54	54.00
BMI
18.5–25: normal weight			7	17.95	23	37.70	30	30.00	0.064
25–30: overweight			23	58.97	26	42.62	49	49.00
30–35: obesity			9	23.08	8	13.11	17	17.00
35–40: obesity II°			0	0.00	1	1.64	1	1.00
>40: obesity III°			0	0.00	3	4.92	3	3.00
Marital status
Single			20	51.28	28	45.90	48	48.00	0.749
In relationship			19	48.72	33	54.10	52	52.00
Education
Primary			11	28.21	11	18.03	22	22.00	0.037
Secondary			22	56.41	26	42.62	48	48.00
Higher			6	15.38	24	39.34	30	30.00
Place of residence
City			17	43.59	34	55.74	51	51.00	0.327
Countryside			22	56.41	27	44.26	49	49.00
Occupational activity
Working			16	41.03	39	63.93	55	55.00	0.041
Not working			23	58.97	22	36.07	45	45.00
Hypertension
Stage 1			3	7.69	14	22.95	17	17.00	0.139
Stage 2			22	56.41	28	45.90	50	50.00
Stage 3			14	35.90	19	31.15	33	33.00
Comorbidities
Diabetes			20	51.28	13	21.31	33	33.00	0.004
Hypercholesterolemia			16	41.03	35	57.38	51	51.00	0.164
Ischemic heart disease			12	30.77	15	24.59	27	27.00	0.654
Renal failure			8	20.51	4	6.56	12	12.00	0.056
Heart failure			2	5.13	4	6.56	6	6.00	1
Blood pressure measurement
2–3 a day			2	5.13	7	11.48	9	9.00	0.651
Once a day			14	35.90	24	39.34	38	38.00
Once a week			9	23.08	10	16.39	19	19.00
When feeling bad			14	35.90	20	32.79	34	34.00
Ability to recognize symptoms of hypertension
Yes			16	41.03	43	70.49	59	59.00	0.007
No			23	58.97	18	29.51	41	41.00
Knowledge of hypertension complications
Yes			12	30.77	37	60.66	49	49.00	0.007
No			27	69.23	24	39.34	51	51.00
Hospitalizations due to hypertension
1–2			19	48.72	47	77.05	66	66.00	0.007
3–5			20	51.28	14	22.95	34	34.00
Medications
Angiotensin-converting enzyme			3	7.69	13	21.31	16	16.00	0.125
Angiotensin receptor antagonists			13	33.33	20	32.79	33	33.00	1
Diuretics			13	33.33	15	24.59	28	28.00	0.471
Adrenergic blockers			14	35.90	14	22.95	28	28.00	0.239
Calcium channel blockers			3	7.69	7	11.48	10	10.00	0.736
Features	Drowsiness (N=39)		Lack of drowsiness (N=61)			Total (N=100)			Pb
	M (SD)	Me (Q1–Q3)	M (SD)	Me (Q1–Q3)		M (SD)	Me (Q1–Q3)
Age (years)	69.8 (14.2)	70 (61–79.5)	60.9 (15.6)	64 (49–70)		64.4 (15.6)	65.5 (52–77)		0.005
High (cm)	168.5 (10.8)	172 (163.5–178.5)	170.3 (10.8)	170 (165–179)		169.6 (10.8)	170 (164–179)		0.557
Weight (kg)	78.4 (12.8)	78 (69–89)	77.8 (13.8)	76 (69–85)		78.1 (13.3)	76.5 (69–88)		0.761
Disease duration (years)	16.9 (7.6)	15 (11–21.5)	13.7 (7.8)	13 (7–18)		15 (7.8)	14 (9.8–20)		0.049

Notes:

a For BMI, renal and heart failure, the frequency of blood pressure measurements, and intake of calcium channel blockers – the exact Fisher’s test (due to the low expected values in the table); for other variables – chi-squared test.

b For age – Student’s t-test (normal distribution); for other variables – Mann–Whitney U test (due to the lack of normal distribution). N, number of patients; P, level of statistical significance.

Abbreviations: BMI, body mass index; M, mean; Me, median; Q1, first quartile; Q3, third quartile.

Table 2 Sociodemographic and clinical data of persons with and without insomnia

Features			Insomnia (N=59)		Lack of insomnia (N=41)		Total (N=100)		Pa
			N	%	N	%	N	%
Sex
Female			25	42.37	21	51.22	46	46.00	0.503
Male			34	57.63	20	48.78	54	54.00
BMI
18.5–25: normal weight			14	23.73	16	39.02	30	30.00	0.042
25–30: overweight			34	57.63	15	36.59	49	49.00
30–35: obesity			10	16.95	7	17.07	17	17.00
35–40: obesity II°			1	1.69	0	0.00	1	1.00
>40: obesity III°			0	0.00	3	7.32	3	3.00
Marital status
Single			31	52.54	17	41.46	48	48.00	0.375
In relationship			28	47.46	24	58.54	52	52.00
Education
Primary			15	25.42	7	17.07	22	22.00	0.109
Secondary			31	52.54	17	41.46	48	48.00
Higher			13	22.03	17	41.46	30	30.00
Place of residence
City			29	49.15	22	53.66	51	51.00	0.81
Countryside			30	50.85	19	46.34	49	49.00
Occupational activity
Working			25	42.37	30	73.17	55	55.00	0.005
Not working			34	57.63	11	26.83	45	45.00
Hypertension
Stage 1			7	11.86	10	24.39	17	17.00	0.014
Stage 2			26	44.07	24	58.54	50	50.00
Stage 3			26	44.07	7	17.07	33	33.00
Comorbidities
Diabetes			23	38.98	10	24.39	33	33.00	0.19
Hypercholesterolemia			23	38.98	28	68.29	51	51.00	0.007
Ischemic heart disease			21	35.59	6	14.63	27	27.00	0.036
Renal failure			10	16.95	2	4.88	12	12.00	0.115
Heart failure			5	8.47	1	2.44	6	6.00	0.396
Blood pressure measurement
2–3 a day			6	10.17	3	7.32	9	9.00	0.361
Once a day			26	44.07	12	29.27	38	38.00
Once a week			9	15.25	10	24.39	19	19.00
When feeling bad			18	30.51	16	39.02	34	34.00
Ability to recognize symptoms of hypertension
Yes			29	49.15	30	73.17	59	59.00	0.028
No			30	50.85	11	26.83	41	41.00
Knowledge of hypertension complications
Yes			21	35.59	28	68.29	49	49.00	0.003
No			38	64.41	13	31.71	51	51.00
Hospitalizations due to hypertension
1–2			29	49.15	37	90.24	66	66.00	<0.001
3–5			30	50.85	4	9.76	34	34.00
Medications
Angiotensin-converting enzyme			10	16.95	6	14.63	16	16.00	0.973
Angiotensin receptor antagonists			23	38.98	10	24.39	33	33.00	0.19
Diuretics			18	30.51	10	24.39	28	28.00	0.657
Adrenergic blockers			15	25.42	13	31.71	28	28.00	0.644
Calcium channel blockers			5	8.47	5	12.20	10	10.00	0.736
Features	Insomnia (N=39)		Lack of insomnia (N=61)			Total (N=100)			Pb
	M (SD)	Me (Q1–Q3)	M (SD)	Me (Q1–Q3)		M (SD)	Me (Q1–Q3)
Age (years)	69.4 (14.6)	70 (60.5–80)	57.1 (14.2)	59 (49–68)		64.4 (15.6)	65.5 (52–77)		<0.001
High (cm)	168.2 (10.5)	169 (161–174.5)	171.7 (11)	171 (166–181)		169.6 (10.8)	170 (164–179)		0.053
Weight (kg)	76.6 (11.1)	78 (69–88)	80.1 (16)	75 (70–90)		78.1 (13.3)	76.5 (69–88)		0.521
Disease duration (years)	16.7 (7.9)	15 (11–22)	12.5 (7.1)	12 (7–17)		15 (7.8)	14 (9.8–20)		0.049

Notes:

a For BMI, renal and heart failure, the frequency of blood pressure measurements, and intake of calcium channel blockers – the exact Fisher’s test (due to the low expected values in the table); for other variables – chi-squared test.

b For age – Student’s t-test (normal distribution); for other variables – Mann–Whitney U test (due to the lack of normal distribution). N, number of patients; P, level of statistical significance.

Abbreviations: BMI, body mass index; M, mean; Me, median; Q1, first quartile; Q3, third quartile.

Table 3 Correlations between sociodemographic variables and the result of the ESS questionnaire

Variables	Spearman correlation coefficient (rho)		Pa
	M (SD)	Me (Q1–Q3)
Age	rho =0.338		0.001
Disease duration	rho =0.248		0.013
Sex
Female	9.35 (2.84)	9 (8–12)	0.379
Male	9.85 (2.84)	10 (7.25–12)
BMI
Normal weight	8.57 (2.66)	8.5 (7–10)	0.042
Overweight	10.22 (2.69)	10 (8–13)
Obesity	9.71 (3.12)	10 (8–12)
Marital status
Single	9.77 (2.88)	10 (8–12)	0.555
In relationship	9.48 (2.82)	9.5 (7–12)
Education
Primary	10.5 (2.48)	10.5 (9–12)	0.022
Secondary	9.9 (2.87)	10 (7.75–12)
Higher	8.53 (2.78)	8 (6.25–10)
Place of residence
City	9.06 (2.79)	9 (7–12)	0.043
Countryside	10.2 (2.8)	10 (8–12)
Occupational activity
Working	9 (2.68)	9 (7–11)	0.011
Not working	10.38 (2.87)	11 (9–13)
Hypertension
Stage 1	8.47 (2.53)	8 (7–9)	0.077
Stage 2	9.56 (3.09)	9.5 (7–12)
Stage 3	10.3 (2.43)	10 (9–12)

Notes:

a Mann–Whitney U test or Kruskal–Wallis test. P, level of statistical significance.

Abbreviations: BMI, body mass index; ESS, Epworth Sleepiness Scale; M, mean; Me, median; Q1, first quartile; Q3, third quartile.

Table 4 Correlations between sociodemographic variables and the result of the AIS questionnaire

Variables	Spearman correlation coefficient (rho)		Pa
	M (SD)	Me (Q1–Q3)
Age	rho =0.337		0.001
Disease duration	rho =0.177		0.078
Sex
Female	7.7 (4.7)	6.5 (4–11)	0.716
Male	7.61 (4.76)	8 (3.25–10)
BMI
Normal weight	6.8 (5.25)	4.5 (3–9.5)	0.137
Overweight	8.22 (4.04)	9 (5–10)
Obesity	7.52 (5.37)	6 (4–11)
Marital status
Single	8.38 (4.92)	8 (4.75–11)	0.113
In relationship	6.98 (4.45)	6.5 (3–9.25)
Education
Primary	8.64 (4.68)	8.5 (5–11.75)	0.071
Secondary	8.06 (4.75)	8 (4–10.25)
Higher	6.27 (4.51)	4 (3–8.75)
Place of residence
City	7.18 (4.05)	7 (3.5–10)	0.621
Countryside	8.14 (5.31)	8 (4–11)
Occupational activity
Working	6.13 (3.88)	5 (3–8)	<0.001
Not working	9.51 (5)	10 (6–12)
Hypertension
Stage 1	6.71 (4.37)	5 (4–8)	0.185
Stage 2	7.3 (5.08)	6.5 (3–10.75)
Stage 3	8.67 (4.23)	9 (6–10)

Notes:

a Mann–Whitney U test or Kruskal–Wallis test. P, level of statistical significance.

Abbreviations: AIS, Acceptance of Illness Scale; BMI, body mass index; M, mean; Me, median; Q1, first quartile ; Q3, third quartile.

Table 5 Correlations for sleep disturbances and QOL

WHOQOL-BREF	Correlations with questionnaires
	ESS		AIS
	Pearson correlation	P-value	Pearson correlation	P
QOL perception	−0.478	<0.001	−0.432	<0.001
Health perception	−0.278	0.005	−0.295	0.003
Physical domain	−0.565	<0.001	−0.582	<0.001
Psychological domain	−0.554	<0.001	−0.52	<0.001
Social domain	−0.544	<0.001	−0.446	<0.001
Environmental domain	−0.546	<0.001	−0.437	<0.001

Note: P, level of statistical significance.

Abbreviations: AIS, Acceptance of Illness Scale; ESS, Epworth Sleepiness Scale; QOL, quality of life; WHOQOL-BREF, World Health Organization Quality of Life-Brief.

Figure 1 Correlations for sleep disturbances in ESS and QOL.

Abbreviations: ESS, Epworth Sleepiness Scale; QOL, quality of life.