Psychological Stress, Sleep Quality, and Blood Pressure in Young Adults: Cross-Sectional Study

Abstract

Background: Blood pressure regulation is influenced not only by biological and lifestyle factors but also by psychological and behavioral determinants, including psychological stress and sleep quality. Chronic stress and sleep disturbances may activate the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis, contributing to elevated blood pressure even in young adulthood.
Objective: To examine the association between psychological stress, sleep quality, and blood pressure among young adults aged 20–40 years.
Methods: This observational cross-sectional study was conducted in Pandanan Village, Klaten Regency, Central Java, Indonesia, from March to May 2025. A total of 100 adults aged 20–40 years were recruited using purposive sampling. Psychological stress was assessed using the Perceived Stress Scale (PSS), sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), and blood pressure was measured using a calibrated digital sphygmomanometer. Blood pressure categories were defined according to international standards. Associations were analyzed using the chi-square test with a significance level of 0.05.
Results: Psychological stress was significantly associated with blood pressure status (p = 0.004), with a higher prevalence of elevated blood pressure observed among participants reporting severe to very severe stress levels. Sleep quality was also significantly associated with blood pressure (p < 0.001), with poor sleep quality predominating among participants with elevated blood pressure.
Conclusion: Higher psychological stress levels and poor sleep quality are significantly associated with elevated blood pressure among young adults. These findings highlight the importance of stress management and sleep quality improvement as components of early, non-pharmacological strategies for blood pressure control.