Sleep Quality of Patient Hypertension with Obstructive Sleep Apnea (OSA) in the Elderly
DOI:
https://doi.org/10.35960/vm.v19i2.2071Keywords:
Epworth Sleepiness Scale, Hypertension, Obstructive Sleep Apnea, Pittsburgh Sleep Quality IndexAbstract
Background: Hypertension is a common chronic health problem in older adult and is often associated with sleep disorders, one of which is the risk of Obstructive Sleep Apnoea (OSA). OSA can cause sleep fragmentation and intermittent hypoxia, which can lead to a decline with hypertension, sleep disorders often go undetected early on requiring effective screening efforts. Purpose: This study aims to analyze the relationship between sleep quality and the risk of Obstructive Sleep Apnoea (OSA) in elderly people with hypertension. Methods: This study employed an analytical observational design with a cross-sectional approach. This study was conducted at the Neurology Clinic of RSI Jemursari Surabaya from May to August 2025 with a sample size of 30 elderly individuals selected using simple random sampling. Sleep quality was measured using the Pittsburgh Slee Quality Index (PSQI), while the risk of OSA was assessed using the Epworth Sleepiness Scale (ESS). The relationship between sleep quality and the risk of OSA was analysed usinhg Fisher’s exact test with a significance level of 0.05. Result: The result showed that most elderly people with hypertension had poor sleep quality (PSQI > 5). Elderly people with a poor sleep quality were significantly more likely to have an ESS score ≥10, indicating an increased risk of Obstructive Sleep Apnoea, compared to elderly people with good sleep quality (p = 0.021). Conclusion: There is a significant relationship between sleep quality and the risk of Obstructive Sleep Apnoea in elderly people with hypertension. Screening for sleep quality and OSA risk using the PSQI and ESS is important as an early detection measure to support the prevention of cardiovascular complications improve the quality of life of elderly people.
References
Bangash, F. K., Pasha, S. F., & Ahmad, U. (2020). Sleep apnea and vascular dysfunction: Pathophysiological mechanisms and clinical implications. Hypertension Research, 43(2), 121–130.
Benetos, A., Petrovic, M., & Strandberg, T. (2019). Hypertension management in older and frail older patients. Journal of Hypertension, 37(2), 234–245.
Benjafield, A. V., Ayas, N. T., Eastwood, P. R., et al. (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea. The Lancet Respiratory Medicine, 7(8), 687-698.
Berry, R. B., Brooks, R., Gamaldo, C. E., Harding, S. M., Lloyid, R. M., Quan, S. F., & Troester, M. T. (2017). The AASM manual for the scoring of sleep and associated events. Journal of Clinical Sleep Medicine, 13(5), 665-666.
Bonsignore, M. R., McNicholas, W. T., Montserrat, J. M., & Eckel, J. (2019). Adipose tissue in obesity and obstructive sleep apnoea. European Respiratory Review, 28(151), 190021.
Bouloukaki, I., Mermigkis, C., Tzanakis, N., et al. (2020). Evaluation of blood pressure patterns in obstructive sleep apnea patients. Journal of Hypertension, 38(2), 238-246.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.
Crowley, K. (2019). Sleep and sleep disorders in older adults. Sleep Medicine Clinics, 14(2), 161–173.
Eckert, D. J., White, D. P., Jordan, A. S., Malhotra, A., & Wellman, A. (2013). Defining phenotypic causes of obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 188(8), 996–1004.
Fava, C., Dorigoni, S., Dalle Vedove, F., et al. (2018). Effect of obstructive sleep apnea severity on blood pressure variability. Journal of Hypertension, 36(1), 120–129.
Franklin, K. A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the elderly. Sleep Medicine Reviews, 20, 29–36.
Ghavami, M., Gilani, S. I., & Mohsenin, V. (2023). Age-related mechanisms of obstructive sleep apnea. Sleep Medicine, 104, 15–23.
Gottlieb, D. J., & Punjabi, N. M., (2020). Epidemiology of Obstructive sleep apnea: A population health perspective. Chest, 157(5), 1319-1328.
Handayani, R., Pradono, J., & Anwar, A. (2023). Sleep quality and hypertension among older in Indonesia. Kesmas: National Public Health Journal, 18(1), 45-53.
Javaheri, S., Barbé, F., Campos-Rodriguez, F., et al. (2018). Sleep apnea: Types, mechanism, and clinical cardiovascular consequences. Circulation, 138(17), 1840-1850.
Javaheri, S., & Redline, S. (2020). Sleep apnea diagnosis and management: A clinical review. The Lancet Respiratory Medicine, 8(8), 821–834.
Javaheri, S., & Redline, S. (2020). Sleep apnea diagnosis and management: A clinical review. The Lancet Respiratory Medicine, 8(8), 821-834.
Johns, M. W. (1991). A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep, 14(6), 540-545.
Jordan, A. S., McSharry, D. G., & Malhotra, A. (2014). Adult obstructive sleep apnoea. The Lancet, 383(9918), 736-747.
Kapur, V. K., Auckley, D. H., Chowdhuri, S., et al. (2017). Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea. Journal of Clinical Sleep Medicine, 13(3), 479-504.
Kandzerska, T., Smith, P. M., Brignardello-Petersen, R., Leung, R. S., & Tomlinson, G. (2014). Evaluation of the Epworth Sleepiness Scale in obstructive sleep apnea. Sleep, 37(3), 427-435.
Laurent, S., Boutouyrie, P., & Cunha, P. G. (2020). Concept of arterial stiffness in aging and hypertension. Hypertension, 76(4), 1024–1031.
Liu, X., Zhang, Y., & Wang, Z. (2019). Comorbidities associated with obstructive sleep apnea. Sleep Medicine Reviews, 46, 101–110.
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Circulation, 141(12), 933–945.
Miner, B., & Kryger, M. H. (2017). Sleep disorders in the aging population. Sleep Medicine Clinics, 12(1), 31–41.
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C. M., & Colantonio, A. (2016). The Pittsburgh Sleep Quality Index as a screening tool. Sleep Medicine Reviews, 25, 52–73.
Ohayon, M. M., Carskadon, M. A., Guilleminault, C., & Vitiello, M. V. (2017). Meta- analysis of sleep changes in aging. Sleep, 40(5), zsx070.
Parati, G., Lombardi, C., Hedner, J., et al. (2014). Position paper on the management of patients with obstructive sleep apnea and hypertension. European Respiratory Journal, 44(4), 1059–1075.
Pedrosa, R. P., Drager, L. F., Gonzaga, C. C., et al. (2016). Obstructive sleep apnea and resistant hypertension. Hypertension, 68(1), 123–130.
Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. New England Journal of Medicine, 342(19), 1378–1384.
Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136–143.
Redeker, N. S., Jeon, S., Muench, U., Campbell, D., Walsleben, J., & Rapoport, D. M. (2019). Insomnia symptoms and daytime function in older adults. Journal of Clinical Nursing, 28(1–2), 200–210.
Senaratna, C. V., Perret, J. L., Lodge, C. J., et al. (2021). Prevalence and risk factors of obstructive sleep apnea. Sleep Medicine Reviews, 56, 101408.
Shiina, K., Tomiyama, H., Takata, Y., et al. (2024). Impact of obstructive sleep apnea on hypertension progression. Hypertension Research, 47, 1–10.
Somers, V. K., White, D. P., Amin, R., et al. (2008). Sleep apnea and cardiovascular disease. Circulation, 118(10), 1080–1111.
Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA guideline for high blood pressure. Hypertension, 71(6), e13–e115.
World Health Organization. (2021). Hypertension fact sheet. World Health Organization.
Zhou, B., Carrillo-Larco, R. M., Danaei, G., et al. (2021). Worldwide trends in hypertension prevalence. The Lancet, 398(10304), 957–980
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Shobihatus Syifak, Dyah Yuniati, Nurlisa Naila Aulia, iis noventi (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Submitted paper will be firstly reviewed by the editors to determine whether the paper meet the edition theme and submission guidelines. Papers which meet the theme and the guidelines will be assigned to selected reviewers for peer-reviews. Viva Medika: Jurnal Kesehatan, Kebidanan dan Keperawatan is a double blind peer-reviewed journal which involves reviewers based on their experties relevant to the topic of the paper. Final decision of paper acceptance is solely decided by the editors according to reviewers' comment.
Plagiarism and self-plagiarism are prohibited. Viva Medika: Jurnal Kesehatan, Kebidanan dan Keperawatan uses Turnitin, PlagiarismCheckerX or iThenticate to scan papers for detecting plagiarism. Thus, Appropriate citation and quotation should be used
.png)

