QUESTIONNAIRE

TITLE:

Sleep Quality and Blood Pressure Control in Patients with Hypertension Attending a
Primary Care Facility in Ghana

Dear Participant,
You are invited to participate in this study assessing sleep quality and blood pressure control
among patients with hypertension. The information you provide will be treated with strict
confidentiality and used solely for research purposes. Participation is voluntary, and you may
withdraw at any time without any consequences to your care.

Please answer the questions as honestly as possible.

SECTION A: SOCIO-DEMOGRAPHIC FACTORS

A1. Age Group A5. Occupation

☐ 18–29 years ☐ Unemployed

☐ 30–39 years ☐ Farmer
☐ 40–49 years ☐ Trader
☐ 50–59 years ☐ Civil/Public servant
☐ 60–69 years ☐ Artisan
☐ ≥70 years ☐ Professional
☐ Retired
A2. Sex ☐ Other (Specify): ___________________

☐ Male
☐ Female
A6. Do you engage in shift work?

☐ Yes
A3. Marital Status ☐ No

☐ Single If Yes:
☐ Married
☐ Cohabiting A7. Type of Shift Work
☐ Divorced/Separated
☐ Widowed ☐ Night shifts
☐ Rotating shifts
☐ Evening shifts
☐ Other (Specify): ___________________
A4. Highest Educational Level Attained

☐ No formal education
☐ Primary education
☐ Junior High School
☐ Senior High School
☐ Tertiary education
SECTION B: HEALTH-RELATED FACTORS

B1. How long ago were you diagnosed ☐ Always

with hypertension? ☐ Often

☐ Less than 1 year

☐ 1–5 years ☐ Sometimes
☐ 6–10 years ☐ Rarely
☐ More than 10 years ☐ Never

B2. Do you have any other medical B4. In the past 2 weeks, how many times
condition(s)? did you miss your antihypertensive
medication?
☐ Yes
☐ No ☐ None
☐ 1–2 times
If Yes, tick all that apply: ☐ 3–5 times
☐ Diabetes mellitus ☐ More than 5 times
☐ Obesity
☐ Kidney disease B5. What is the major reason for missing
☐ Heart disease your medication?
☐ Stroke
☐ Asthma/COPD ☐ Forgot
☐ Depression ☐ Side effects
☐ Obstructive sleep apnea ☐ Financial difficulty
☐ Other (Specify): ___________________ ☐ Felt better
☐ Drug unavailable
☐ Other (Specify): ___________________

Medication Adherence
Stress Assessment
B3. Do you take your antihypertensive
medications as prescribed? B6. How often do you feel stressed?
☐ Never Depression Screening
☐ Rarely
☐ Sometimes B8. During the past two weeks, have you
☐ Often often felt down, depressed, or hopeless?
☐ Always
☐ Yes
B7. What is the main source of stress? ☐ No

☐ Work B9. During the past two weeks, have you

☐ Financial issues had little interest or pleasure in doing
☐ Family problems things?
☐ Health condition
☐ Other (Specify): ___________________ ☐ Yes
☐ No

SECTION C: BEHAVIOURAL / LIFESTYLE FACTORS

Physical Activity ☐ 1–5
☐ 6–10
C1. Do you engage in regular physical ☐ More than 10
activity or exercise?

☐ Yes
☐ No Alcohol Use

C2. If Yes, how many days per week? C7. Do you consume alcohol?

☐ 1–2 days ☐ Yes

☐ 3–4 days ☐ No
☐ ≥5 days
If Yes:
C3. Average duration of exercise per
session C8. How often do you consume alcohol?

☐ Less than 30 minutes ☐ Daily

☐ 30–60 minutes ☐ Weekly
☐ More than 60 minutes ☐ Occasionally
☐ Rarely

Cigarette Smoking
Caffeine Consumption
C4. Have you ever smoked cigarettes?
C9. Do you consume caffeinated drinks
☐ Yes (coffee, tea, energy drinks, cola)?
☐ No
☐ Yes
C5. Do you currently smoke cigarettes? ☐ No

☐ Yes
☐ No

C10. How often do you consume

caffeinated drinks?

If Yes: ☐ Daily
☐ 3–5 times/week
C6. Number of cigarettes smoked per day ☐ 1–2 times/week
☐ Occasionally
C11. Do you consume caffeinated drinks
within 4 hours before bedtime?

☐ Yes
☐ No

SECTION D: SLEEP QUALITY ASSESSMENT

Pittsburgh Sleep Quality Index (PSQI)

Instructions:

The following questions relate to your usual sleep habits during the past ONE month only. Your
answers should indicate the most accurate reply for the majority of days and nights in the past
month.

D1. During the past month, what time have you usually gone to bed at night?

Time: ___________

D2. During the past month, how long (in minutes) has it usually takes you to fall asleep
each night?

___________ minutes

D3. During the past month, what time have you usually gotten up in the morning?

Time: ___________

D4. During the past month, how many hours of actual sleep did you get at night?

___________ hours

D5. During the past month, how often have you had trouble sleeping because you:
 Not during the Less than Once or Three or more
Problem
past month once a week twice a week times a week
a. Cannot get to sleep within 30
☐ ☐ ☐ ☐
minutes
b. Wake up in the middle of the
☐ ☐ ☐ ☐
night or early morning
c. Have to get up to use the
☐ ☐ ☐ ☐
bathroom
d. Cannot breathe comfortably ☐ ☐ ☐ ☐
e. Cough or snore loudly ☐ ☐ ☐ ☐
f. Feel too cold ☐ ☐ ☐ ☐
g. Feel too hot ☐ ☐ ☐ ☐
h. Had bad dreams ☐ ☐ ☐ ☐
i. Have pain ☐ ☐ ☐ ☐
j. Other reason(s), please
☐ ☐ ☐ ☐
describe: ___________

D6. During the past month, how would you rate your sleep quality overall?

☐ Very good
☐ Fairly good
☐ Fairly bad
☐ Very bad

D7. During the past month, how often have you taken medicine to help you sleep?

☐ Not during the past month

☐ Less than once a week
☐ Once or twice a week
☐ Three or more times a week

D8. During the past month, how often have you had trouble staying awake while driving,
eating meals, or engaging in social activity?

☐ Not during the past month

☐ Less than once a week
☐ Once or twice a week
☐ Three or more times a week

D9. During the past month, how much of a problem has it been for you to keep up enough
enthusiasm to get things done?

☐ No problem at all
☐ only a very slight problem
☐ somewhat of a problem
☐ A very big problem

D10. Does your bed partner or roommate observe any of the following?

Not during Less than Once or Three or more

Observation
past month once a week twice a week times a week
Loud snoring ☐ ☐ ☐ ☐
Long pauses between breaths while
☐ ☐ ☐ ☐
asleep
Leg twitching during sleep ☐ ☐ ☐ ☐
Episodes of
confusion/disorientation during ☐ ☐ ☐ ☐
sleep

SECTION E: BLOOD PRESSURE CONTROL

(To be completed by researcher/health professional)

E1. Current Blood Pressure Reading

Systolic BP: __________ mmHg
Diastolic BP: __________ mmHg

E2. Blood Pressure Status

☐ Controlled (<140/90 mmHg)

☐ Uncontrolled (≥140/90 mmHg)

E3. Weight: __________ kg

E4. Height: __________ m

E5. BMI: __________ kg/m²

THANK YOU

Thank you for participating in this study.

Your contribution is highly appreciated.