Associations of Blood Pressure Control with Sleep Quality, Quality of Life and Lifestyle Factors among Indian Adults with Hypertension: A Multicenter Real-World Study

Background Hypertension may be associated with impaired sleep quality and health-related quality of life (QOL). Real-world evidence examining these outcomes together with blood pressure (BP) control and lifestyle factors among Indian adults with hypertension remains limited. Methods This retrospective observational study included 950 adults with essential hypertension receiving routine clinical care across multiple centers in India. Sleep quality and hypertension-specific QOL were assessed using the Pittsburgh Sleep Quality Index (PSQI) and MINICHAL questionnaire, respectively. Associations were assessed using chi-square tests and independent-samples t-tests. Multivariable logistic regression using forced entry evaluated factors associated with poor sleep quality. BP changes between baseline and approximately one-month follow-up were assessed using paired t-tests. Results Poor sleep quality was present in 81.4% of participants. Poor sleep occurred in 78.7% of patients with controlled and 83.6% with uncontrolled BP (OR 1.39, 95% CI 1.00–1.92; p = 0.054). Mean PSQI scores were higher in uncontrolled versus controlled BP groups (8.55 ± 4.03 vs. 7.56 ± 3.51; mean difference − 0.99, 95% CI − 1.48 to − 0.51; p < 0.001). Mean MINICHAL scores were also higher in uncontrolled versus controlled BP groups (28.06 ± 11.79 vs. 24.34 ± 11.92; mean difference − 3.72, 95% CI − 5.24 to − 2.20; p < 0.001). Caffeine consumption within three hours before bedtime showed a borderline adjusted association with poor sleep (aOR 1.43, 95% CI 1.00–2.05; p = 0.052). SBP and DBP decreased by 18.62 and 14.11 mmHg, respectively, during follow-up (p < 0.001). Conclusion Poor sleep and impaired QOL were highly prevalent in hypertensive patients. Uncontrolled BP was associated with modestly poorer sleep and QOL. Caffeine timing showed a borderline association with poor sleep. BP reduction represents an observed longitudinal change rather than evidence of treatment efficacy.