Gender disaggregated association of sleep disturbance with hypertension in a rural community of Uttarakhand

Q: What are the key findings of this study?

Poor sleep quality was independently associated with a 39% increased odds of hypertension (aOR 1.39) among adults in rural Uttarakhand, with the association being particularly significant in women.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=1946). Intervention: Poor sleep quality vs. Good sleep quality. Primary outcome: Hypertension (aOR 1.39, 95% CI 1.13-1.72, p=0.002).

Q: What does this research mean for the field?

Poor sleep quality is an independent determinant of hypertension among adults in rural Uttarakhand, with the association being especially pronounced in women. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Vartika Saxena; Rohit Katre; Pallavi Singh

doi:10.1186/s12982-026-02600-y

August 6, 2026Discover Public HealthOpen Access

Gender disaggregated association of sleep disturbance with hypertension in a rural community of Uttarakhand

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Key result

Poor sleep quality linked to ~39% higher hypertension risk, particularly in women.

aOR 1.39
95% CI 1.13-1.72
P=0.002
n=1,946

Why the study?

Hypertension is a major public health challenge predominantly affecting low- and middle-income countries, prompting investigation into the association between sleep quality and hypertension in rural India.

Does poor sleep quality associate with hypertension in adults in rural India?

Key Points

To evaluate the association between sleep quality and hypertension status among adults in rural Uttarakhand, India, and assess whether this relationship varies by gender.
Conducted a community-based cross-sectional survey from April 2018 to November 2019 across 30 randomly selected villages in Doiwala block, Dehradun, Uttarakhand, India.
Recruited N=1,946 adults aged ≥19 years through multistage sampling for household interviews, blood pressure assessment, and random blood glucose testing.
Measured sleep quality on a 4-point scale (dichotomized into good vs poor), evaluated stress using the 10-item Perceived Stress Scale (PSS-10), and performed multivariable logistic regression analysis.
Sleep disturbance was significantly associated with hypertension across both genders combined (p < 0.05).
Multivariate regression identified sleep quality as an independent determinant of hypertension overall and specifically among females on gender-stratified analysis (p < 0.05).

Study Design

Type

Cross-Sectional (n=1,946)

Structured PICO

Does poor sleep quality associate with hypertension in adults in rural India?

P

Population

1,946 adults aged 19 years and older from a rural community in Uttarakhand, India, were evaluated in a cross-sectional survey to determine the association between sleep quality and hypertension.

E

Exposure

Poor sleep quality (self-rated as bad or very bad on a 4-point scale)

C

Comparator

Good sleep quality (self-rated as good or average)

O

Outcome

Hypertension status (SBP ≥140 mmHg, DBP ≥90 mmHg, or on antihypertensive treatment)

Main Result

Odds Ratio: 1.39 (95% CI 1.13–1.72)

p-value: p=0.002

Poor sleep quality is an independent risk factor for hypertension in rural Indian adults, particularly among women, highlighting the need for sleep assessment in community NCD screening.

Limitations

Cross-sectional study design precludes causal inference about the temporality of the sleep-hypertension relationship
Sleep quality was assessed using a single self-rated question rather than a validated multi-item instrument
Perceived stress was measured subjectively without objective biological stress markers
Physical activity was captured using a single-item measure for leisure-time involvement only
Gender-stratified logistic regression was performed without formal adjustment for multiplicity

Implication

Sleep quality may be associated with hypertension in rural Indian adults; leaves open causal role and need for longitudinal data before practice change.

Abstract

Hypertension is a significant public health challenge in 21st century. It is also described as “Silent killer”. More than three-fourths of patients suffering from hypertension reside in low- and middle-income countries (LMICs). India, a developing economy, is in the midst of epidemiological and nutrition transition with significant double burden from communicable and non-communicable diseases. The present study was undertaken with an objective to determine the association between sleep quality and hypertension status among adults in rural Uttarakhand, India. It was a community-based cross-sectional study conducted from April 2018 to November 2019 in Doiwala block of Dehradun, Uttarakhand, India. A total of 1946 participants were included in the study. Pre-structured, pre-validated tool was used for collection of data and a p-value of < 0.05 was considered statistically significant. Sleep disturbance was significantly associated with hypertension in both gender (p < 0.05). On multivariate regression analysis, sleep was found an independent determinant of hypertension. On gender-stratified analysis, sleep was found independent determinant of hypertension among females (p < 0.05). Neither the overall, nor the gender-stratified analyses for association between PSS scores and hypertension was statistically significant. Poor sleep quality is a significant independent determinant of hypertension among adults in rural Uttarakhand, after adjusting for major confounders. Integration of sleep quality assessment into community-level NCD screening programmes, with particular attention to women.

Discussion

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Cite This Study

Saxena et al. (2026) conducted a cross-sectional in Hypertension (n=1,946). Poor sleep quality vs. Good sleep quality was evaluated on Hypertension (aOR 1.39, 95% CI 1.13-1.72, p=0.002). Poor sleep quality was independently associated with a 39% increased odds of hypertension (aOR 1.39) among adults in rural Uttarakhand, with the association being particularly significant in women.

synapsesocial.com/papers/6a76dacaf12abadc79815528 https://doi.org/10.1186/s12982-026-02600-y

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Gender disaggregated association of sleep disturbance with hypertension in a rural community of Uttarakhand

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Gender disaggregated association of sleep disturbance with hypertension in a rural community of Uttarakhand

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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