Tibb-based lifestyle education and sleep and blood pressure changes among university employees with hypertension: A single-group pretest–posttest study

Q: What are the key findings of this study?

A 4-week Tibb-based lifestyle education program reduced mean clinic SBP by 12.83 mmHg (95% CI -16.32 to -9.33; p<0.001) and increased median sleep quality score by 5 points (p<0.001) from baseline.

Q: What is the clinical evidence from this study?

Population: Hypertension (n=29). Intervention: Multicomponent Tibb-based lifestyle education program emphasizing sleep-wake regulation vs. Baseline (pretest within-participant comparison). Primary outcome: Within-participant change in clinic systolic blood pressure (SBP, mmHg) at 4 weeks (MD -12.83 mmHg (Cohen's d_z = -1.40), 95% CI -16.32 to -9.33, p=<0.001).

Q: What does this research mean for the field?

A four-week multicomponent Tibb-based lifestyle education program emphasizing sleep–wake regulation lowers clinic blood pressure and improves self-reported sleep quality in adults with hypertension. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate within-participant changes in sleep quality and clinic blood pressure following a four-week multicomponent Tibb-based lifestyle education program focused on sleep–wake regulation.

Barita Juliano Siregar; Yardi Satibi; Rafly Syah Putra; Ofa Suzanti Betha

doi:10.25077/jsfk.13.02.242-250.2026

October 6, 2026Jurnal Sains Farmasi & KlinisOpen Access

Tibb-based lifestyle education and sleep and blood pressure changes among university employees with hypertension: A single-group pretest–posttest study

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Key result

Tibb-based lifestyle education reduces clinic SBP by ~13 mmHg at 4 weeks.

MD -12.83 mmHg (Cohen's d_z = -1.40)
95% CI -16.32 to -9.33
P<0.001
n=29

Why the study?

Poor sleep may contribute to inadequate blood pressure control, motivating an examination of within-participant changes in sleep and blood pressure after a multicomponent Tibb-based lifestyle education program.

Does a four-week multicomponent Tibb-based lifestyle education program improve self-reported sleep characteristics and clinic blood pressure in university employees with hypertension?

Key Points

To evaluate within-participant changes in sleep quality and clinic blood pressure following a four-week multicomponent Tibb-based lifestyle education program focused on sleep–wake regulation.
Conducted a single-group pretest–posttest study among employees with hypertension (N=29) at an Indonesian Islamic university.
Delivered a four-week multicomponent Tibb-based educational intervention emphasizing sleep–wake regulation, rhythmic breathing, and lifestyle domains with daily messaging reinforcement.
Measured paired outcomes using the seven-item Kuesioner Kualitas Tidur (KKT) and resting clinic blood pressure via an Omron HEM-8712 monitor.
Median KKT total score increased from 16 (IQR 15–17) to 21 (IQR 21–22), with a median paired difference of +5 points (IQR 3–6; Wilcoxon W = 4.0; p < 0.001; rank-biserial correlation = 0.98).
Mean clinic systolic blood pressure decreased from 142.83 ± 15.05 mmHg to 130.00 ± 7.91 mmHg (paired difference −12.83 mmHg; 95% CI −16.32 to −9.33; t(28) = −7.51; p < 0.001; Cohen’s d_z = −1.40).
Mean clinic diastolic blood pressure decreased from 96.14 ± 10.86 mmHg to 86.07 ± 6.45 mmHg (paired difference −10.07 mmHg; 95% CI −13.13 to −7.00; t(28) = −6.73; p < 0.001; Cohen’s d_z = −1.25).

Structured PICO

Does a four-week multicomponent Tibb-based lifestyle education program improve self-reported sleep characteristics and clinic blood pressure in university employees with hypertension?

P

Population

29 Indonesian university employees (27.6% female, aged ≥18 years) with a prior clinical diagnosis of hypertension and current or previous antihypertensive medication use, followed for 4 weeks.

I

Intervention

Four-week multicomponent Tibb-based lifestyle education program emphasizing sleep–wake regulation (also addressing environmental air and breathing, food and drink, movement and rest, emotional regulation, and elimination and retention), delivered via educational sessions, breathing practice, face-to-face assessment, webinar instruction, daily WhatsApp-group reinforcement, infographics, short videos, written guidance, and behavioral reminders.

O

Outcome

Within-participant changes in Kuesioner Kualitas Tidur (KKT) total score, clinic systolic blood pressure (SBP), and clinic diastolic blood pressure (DBP) at approximately one month after baseline (following the 4-week program), measured using a seven-item self-report questionnaire and a single reading on an Omron HEM-8712 automated upper-arm monitor.surrogate

Main Result

Mean Difference: -12.83 (95% CI -16.32–-9.33)

Absolute Event Rate: 130% vs 142.83%

p-value: p=<0.001

A four-week culturally framed Tibb-based lifestyle education program was associated with short-term within-participant improvements in self-reported sleep quality and clinic blood pressure among university employees with hypertension, though uncontrolled design and potential medication confounding preclude causal conclusions.

Limitations

Single-group pretest-posttest design without a concurrent control group prevents causal attribution and separation from regression to the mean
Antihypertensive medication adherence, dose adjustments, and regimen changes were not monitored at follow-up
Clinic blood pressure was based on only a single reading at baseline and follow-up
Incomplete psychometric validation of the Kuesioner Kualitas Tidur (KKT) sleep questionnaire in employees with hypertension
Small sample size (n=29 complete cases out of 32 enrolled) at a single institution with short 4-week follow-up
Multicomponent delivery without objective adherence monitoring precludes isolating individual component effects
Single-group pretest–posttest design without a concurrent control group does not permit causal attribution or separation from regression to the mean
Antihypertensive medication adherence, dose adjustments, and regimen changes were not monitored prospectively during follow-up
Clinic blood pressure was based on a single reading at each assessment rather than an average of repeated readings, and cuff-size selection, measurement arm, time of day, and premeasurement restrictions were not recorded
Comprehensive validation of the Kuesioner Kualitas Tidur (KKT) in employees with hypertension is incomplete
Small single-institution sample (n=29 complete cases out of 32 enrolled) and short follow-up restrict precision, generalizability, and assessment of sustained change

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Implication

Associated with BP and sleep gains in employees; leaves open causal effects and should not change practice.

Abstract

Poor sleep may contribute to inadequate blood pressure control. This preliminary single-group pretest–posttest study examined within-participant changes after a four-week multicomponent Tibb-based lifestyle education program emphasizing sleep–wake regulation. Twenty-nine employees with hypertension from one Indonesian Islamic university completed paired assessments. Sleep-related characteristics were assessed using the seven-item Kuesioner Kualitas Tidur (KKT), and clinic blood pressure was measured using an Omron HEM-8712 monitor. The median KKT score increased from 16 (IQR 15–17) to 21 (IQR 21–22), with a median paired change of +5 points (IQR 3–6; Wilcoxon W = 4.0; p < 0.001; rank-biserial correlation = 0.98). Mean SBP was lower at follow-up (130.00 ± 7.91 vs 142.83 ± 15.05 mmHg; paired difference −12.83 mmHg; 95% CI −16.32 to −9.33; p < 0.001; Cohen’s d_z = −1.40), and DBP was also lower (86.07 ± 6.45 vs 96.14 ± 10.86 mmHg; paired difference −10.07 mmHg; 95% CI −13.13 to −7.00; p < 0.001; Cohen’s d_z = −1.25). Favorable within-participant changes were observed. However, the uncontrolled design, medication-related confounding, single blood-pressure readings, and incomplete validation of the KKT preclude causal or definitive effectiveness conclusions.

Discussion

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Cite This Study

Siregar et al. (2026) studied Hypertension (n=29). Multicomponent Tibb-based lifestyle education program emphasizing sleep-wake regulation vs. Baseline (pretest within-participant comparison) was evaluated on Within-participant change in clinic systolic blood pressure (SBP, mmHg) at 4 weeks (MD -12.83 mmHg (Cohen's d_z = -1.40), 95% CI -16.32 to -9.33, p=<0.001). A 4-week Tibb-based lifestyle education program reduced mean clinic SBP by 12.83 mmHg (95% CI -16.32 to -9.33; p<0.001) and increased median sleep quality score by 5 points (p<0.001) from baseline.

synapsesocial.com/papers/6ae28e75cbadf70daf6c42d0 https://doi.org/10.25077/jsfk.13.02.242-250.2026

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Tibb-based lifestyle education and sleep and blood pressure changes among university employees with hypertension: A single-group pretest–posttest study

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Tibb-based lifestyle education and sleep and blood pressure changes among university employees with hypertension: A single-group pretest–posttest study

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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