Key result
Poor sleep hygiene links to elevated psychological stress, partially mediated by poor sleep quality.
Why the study?
Research was scarce regarding the associations between sleep hygiene, sleep quality, and psychological stress among adults with multiple CVD risk factors.
Does sleep hygiene improve sleep quality and psychological stress in adults with hypertension and type 2 diabetes?
Cross-Sectional (n=300)
Does sleep hygiene improve sleep quality and psychological stress in adults with hypertension and type 2 diabetes?
Effect estimate: Indirect effect 0.16 (95% CI 0.04-0.35)
In adults with multiple cardiovascular risk factors (hypertension and type 2 diabetes), poor sleep hygiene is strongly associated with elevated psychological stress, a relationship that is partially mediated by poor sleep quality.
Association in hypertension and diabetes patients is hypothesis-generating; leaves open whether sleep hygiene interventions reduce stress.
Background: Poor sleep quality and psychological stress are interrelated and disproportionately affect adults with multiple cardiovascular disease (CVD) risk factors. Maintaining an optimal home environment and engaging in healthy bedtime behaviors are important components of sleep hygiene practices that influence sleep health and mental well-being. However, research is scarce in exploring the associations between sleep hygiene, sleep quality, and psychological stress among adults with multiple CVD risk factors. Methods: A cross-sectional study was conducted with 300 adults diagnosed with hypertension and type 2 diabetes. Individuals were recruited from a large academic health center and were asked to complete an online survey. Sleep hygiene was assessed by nine individual factors focusing on negative household environment (safety, physical comfort, temperature, and light) and poor bedtime behaviors (watching TV, playing video games, using small screens, and eating) and by a composite score. Multiple regression and mediation analysis with bootstrapping were employed to examine the associations. Results: Of the sample, 78% reported poor sleep quality and 44% reported high psychological stress. Individual sleep hygiene factors as well as the composite score were significantly associated with poorer sleep quality and higher psychological stress. Sleep quality mediated the association between the composite score and psychological stress (Indirect effect: 0.16; 95% bootstrap confidence interval: 0.04-0.35). Conclusions: The study highlights strong links between sleep hygiene, sleep quality, and psychological stress. Although causality cannot be established, current evidence suggests that promoting home environment and bedtime behaviors may alleviate sleep and psychological burdens in adults with multiple CVD risk factors. CLINICAL PERSPECTIVE: Enhancing room environment and bedtime behaviors is crucial for adults with multiple cardiovascular disease risk factors.Given the crucial roles of both sleep and psychological stress in cardiovascular health, promoting modifiable sleep hygiene practices may be an effective strategy to mitigate health risks in this population.
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Liu et al. (2024) conducted a cross-sectional in Hypertension and type 2 diabetes (n=300). Poor sleep hygiene (home environment and bedtime behaviors) vs. Better sleep hygiene was evaluated on Mediation of the association between sleep hygiene composite score and psychological stress by sleep quality (Indirect effect 0.16, 95% CI 0.04-0.35). Poor sleep hygiene was significantly associated with elevated psychological stress, a relationship that was partially mediated by poor sleep quality (indirect effect 0.16).
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