Mehmet KARAKAŞ, Murat ALTUNTAŞ
İstanbul Medical Journal - 2026;27(1):77-81
Introduction: This cross-sectional study aimed to evaluate the prevalence of poor sleep quality and determine the specific impact of the number, type, and comorbidity (multimorbidity) of chronic diseases on sleep quality among individuals followed in primary care. Methods: This descriptive study, conducted at a family health center in İstanbul, Türkiye, between June and August 2024, included 268 adult patients diagnosed with at least one chronic disease. Data were collected using a sociodemographic and clinical data form and the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses were performed using descriptive statistics and the Mann-Whitney U, Kruskal-Wallis, and Spearman's correlation tests; the significance level was set at p<0.05. Results: Participants' mean age was 54.29+/-17.1 years; 52.6% were female. The mean number of chronic diseases per person was 2.62. The most prevalent diseases were hypertension (36.57%), diabetes mellitus (22.01%), and vitamin D deficiency (17.91%). Poor sleep quality (PSQI >=5) was identified in a high proportion of participants (59.3; n=159). A significant positive correlation was found between the number of chronic diseases (multimorbidity) and the total PSQI score (r: 0.227, p<0.001). Total PSQI scores were significantly higher in individuals with psychiatric diseases (p=0.029), COPD (p=0.003), migraine (p=0.004), and skin diseases (p=0.002). Furthermore, disease clusters, notably the comorbidity of hypertension and diabetes and the combination of vitamin D and B12 deficiencies, exerted a more detrimental effect on sleep quality and daytime functioning than isolated diseases. Conclusion: Sleep disturbances are highly prevalent in primary care patients with chronic conditions. Multimorbidity has been confirmed as an independent risk factor for impaired sleep quality, particularly when it involves psychiatric, respiratory, neurological, and metabolic conditions. Family physicians should prioritize routine sleep quality screening in chronic disease management and integrate personalized, holistic interventions.
