This study investigated the association between sleep quality and comorbidity in community-dwelling patients with hypertension. Patients with hypertension who received medical services at community health service centers in Shushan District, Hefei City in 2025 were enrolled, and data were collected via convenience sampling. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), comorbidity information was obtained through medical history survey, and binary Logistic regression was applied to analyze the association between the two variables.The results showed that the comorbidity detection rate among patients with hypertension was 75.41%. After adjusting for confounding factors, compared with patients with "very good" sleep quality, those with "poor" sleep quality (OR=2.78, 95%CI: 1.40–5.49) and "very poor" sleep quality (OR=11.82, 95%CI: 4.99–28.01) had a elevated risk of comorbidity. Restricted cubic spline (RCS) analysis demonstrated a linearly increasing trend of comorbidity risk with the deterioration of sleep quality (P<0.05).These findings indicate that the poorer the sleep quality of patients with hypertension, the higher their comorbidity risk. Clinical interventions should be implemented to strengthen sleep management, raise awareness of healthy sleep, and identify hypertensive patients with sleep abnormalities at an early stage, so as to reduce the risk of comorbidity.