The study was conducted in the Hypertension OPD, Department of General Medicine, Madras Medical College, Chennai. Two hundred consecutive hypertensive patients who were attending the OPD for follow-up were included as participants in this study after obtaining an informed consent. Patients were included in the study group if they were taking hypertension medication. The control group included non-hypertensive individuals who were patients at the clinic or relatives of patients. Participants with history of co-morbid medical and psychiatric illnesses were excluded from the study. A semi-structured proforma was designed to elicit the socio demographic profile of the participants. Each participant was assessed for the presence of sleep disorders by sleep-50 questionnaire and for quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). Duration of sleep was asked directly to patients and recorded. Statistical analysis was carried out using analysis software SPSS version 20.

Participants’ mean age from the sample was49±12.52. Among the 400 participants who were assessed in the study, 200 were hypertensive and 200 were normotensive. Out of these there were more normal (n - 143) and overweight (n - 35) participants in the normotensive group and more obese (n - 38) in the hypertensive group. Results on sleep and hypertension found that hypertensive participants had poorer sleep quality (29.5 % vs 24 %), shorter sleep duration (23.5 % vs 19 %) and more sleep disorders (9.5 % vs 9, 4.5 %).

Results found that BMI was significantly (p <0.01) correlated with sleep quality, sleep duration, and sleep disorder. Hypertension was not significantly correlated to sleep quality or duration but associated to sleep disorder (<0.05) (table 2).

The aim of the study was to describe the prevalence of sleep disorders, poor quality of sleep and shorter duration of sleep, in hypertensive individuals as compared to the normal population. A similar cross- sectional investigation was made for body mass index.

This study found that more participants with hypertension had poorer sleep quality, shorter sleep duration and more sleep disorders than normotensive participants. These results are aligned with that of a review by Wang et al. where individuals whom reported less than seven hours of sleep had higher risk of hypertension.⁵ Furthermore, the review found that individuals reporting sleep for more than seven hours also posed a risk of hypertension. This study did not find any prevalence among hypertensive individuals and sleep longer than seven hours.

While this study reported a higher frequency of hypertensive participants with poorer quality, lesser duration and disordered sleep, there was no correlation between two of the three sleep variables with hypertension. Only sleep disorder was found to be negatively correlated to hypertension. Similarly studies have found that sleep disorders like insomnia were not associated with hypertension in older adults.⁶ One paper took into consideration short sleep duration as an effect of sleep disorder and found hypertension to be correlated.⁷ However, this study did not find duration of sleep to be significantly correlated.

Another major finding was that BMI was significantly correlated with the sleep variables. Results indicate that greater BMI is associated to lower quality of sleep and lesser duration of sleep. Our results are consistent with other studies that found a significant association between greater BMI and poor sleep duration among women and among samples of young and older adults.^8,9 Conversely, a positive correlation was reported between BMI and sleep disorder. This relationship has been reported in numerous studies relating obesity with sleep apnea, insomnia, and restless leg syndrome.¹⁰ Such papers predict that exercise and weight loss may be effective in reducing risk of BMI related physical conditions.

This study found that body mass index was significantly correlated with sleep variables such as sleep duration, sleep quality, and sleep disorders. Maintaining a healthy BMI could in fact impact the amount and quality of sleep an individual receives. Although all sleep variables were incidentally higher among hypertensive as compared to normotensive patients, two of these variables were not found to be significantly correlated to hypertension. Literature supports these results as well as recommends that exercise be an intervention to reduce BMI and, consequentially, the risk of sleep related problems.