G-3542

The Effect of Cognitive Behavioral Therapy on Sleep Quality and Its Components in Patients with Hypertension: A Quasi-Experimental Study with Follow-up

 Ahmad Sobhani ¹ ©, Marjan Ghazanfari Harandi ², Shaghayegh Beheshtinejad ³ ℗   

 
Abstract

Introduction: Hypertension is a chronic and debilitating disease that can impose significant limitations on an individual’s daily life and adversely affect overall well-being. Sleep quality is recognized as a key factor influencing both the onset and progression of hypertension. Improving sleep quality may therefore play a crucial role in managing hypertensive patients. While pharmacological interventions are essential, behavioral interventions, when implemented alongside medications, may yield better outcomes, lower costs, and fewer physical side effects. This study aimed to investigate the impact of cognitive behavioral therapy (CBT) on sleep quality and its components in patients with hypertension. Methods and Materials: This quasi-experimental study utilized a pre-test, post-test, and follow-up design with a control group. A total of 34 patients with hypertension, who attended medical centers in the north of Isfahan in 2024, were selected through purposive sampling and were randomly and equally assigned to either the experimental or control group. The experimental group participated in eight 90-minute sessions of cognitive behavioral therapy, while the control group received no intervention throughout this period. Data were collected using a demographic questionnaire, and sleep quality was assessed at two stages (pre-test and post-test) with the Pittsburgh Sleep Quality Index (PSQI). Blood pressure was measured and recorded using a digital sphygmomanometer from the beginning to the end of the intervention. Additionally, a follow-up assessment was conducted three months after the completion of the intervention. Data analysis was performed using repeated measures analysis of variance (ANOVA) in SPSS-27 software. Results: The findings from the repeated measures ANOVA indicated a significant interaction between time and group for overall sleep quality as well as for all PSQI components, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction, from pre-test to post-test (p 0.05). This demonstrates that the mean scores for sleep quality and its components significantly improved in the experimental group compared to the control group. Moreover, the improvements observed in the experimental group were maintained at the three-month follow-up (p 0.05). Conclusion and Discussion: Based on the findings of the present study, cognitive behavioral therapy—utilizing techniques such as relaxation, calming skills, and cognitive restructuring—can serve as an effective adjunct to standard medical treatments for improving sleep quality in patients with hypertension.

Keywords: Cognitive behavioral therapy, blood pressure, sleep quality, hypertension