Sleep disorders among elderly hypertensive patients: associated factors and implications for management

Sleep disorders are common comorbidities in elderly hypertensive patients, forming a vicious cycle with hypertension that exacerbates disease progression and impairs quality of life. This study aimed to explore the factors independently associated with sleep disorders in elderly hypertensive patients and provide evidence for clinical management.

A cross-sectional survey was conducted among elderly hypertensive patients admitted to our hospital from June 2025 to October 2025. Data were collected using a self-designed, psychometrically validated questionnaire. Univariate analysis, correlation analysis, and multivariate logistic regression were used to identify associated factors of sleep disorders.

The prevalence of sleep disorders in the enrolled population was 39.02% (206/528). Univariate and correlation analyses showed significant differences and correlations between sleep disorders and age, body mass index (BMI), education level, family per capita monthly income, hypertension course, hypertension grade, regular exercise, and pre-bedtime electronic device use (all P < 0.05). Multivariate logistic regression analysis revealed that advanced age (≥70 years), prolonged hypertension course (≥10 years), high hypertension grade (grade 2-3), lack of regular exercise, and frequent pre-bedtime electronic device use (≥3 times/week) were independently associated with sleep disorders (all P < 0.001). The regression model exhibited good fit (Hosmer-Lemeshow test, P = 0.352) and showed moderate discriminative ability in exploratory analysis.

Sleep disorders are highly prevalent among elderly hypertensive patients. Advanced age, prolonged hypertension duration, severe hypertension, sedentary lifestyle, and frequent pre-bedtime electronic device use were identified as factors independently associated with sleep disturbances. Clinical practice should adopt integrated management strategies, including individualized blood pressure control, routine sleep assessment for high-risk groups, targeted lifestyle interventions, and multidisciplinary collaboration.