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Factors influencing heart failure patients’ sleep quality


T.-J. Wang: e-mail:


wang t.-j., lee s.-c., tsay s.-l. & tung h.-h. (2010) Factors influencing heart failure patients’ sleep quality. Journal of Advanced Nursing66(8), 1730–1740.


Title. Factors influencing heart failure patients’ sleep quality.

Aim.  The aim of the study was to describe the factors influencing the sleep quality of patients with heart failure.

Background.  Sleep problems are common in patients with heart failure, and have a negative impact on their quality of life. Patients with heart failure often have difficulties in lying supine to sleep, falling asleep, and maintaining sleep, as well as waking up too early.

Methods.  A predictive correlational design was used, with 101 patients with heart failure recruited from cardiology clinics in Taiwan. Patients completed questionnaires, and data were collected in 2007. Statistical analyses included descriptive statistics, t-tests, analysis of variance, Pearson product moment correlation coefficients, and multiple regression.

Results.  The mean score for sleep quality was 10·78 (sd = 4·78), as measured by the Pittsburgh Sleep Quality Index. Overall, 81% of participants reported poor sleep quality, and 31% were unsatisfied with the quality of their sleep. Sleep efficacy and hours of sleep during the night were rated as the lowest among the dimensions of sleep quality. The most common reason for interruption of sleep was getting up to urinate at night. Stepwise multiple regression analysis showed that the factors related to sleep quality were gender, perceived health, depressive mood, and the number of comorbidities. These four variables explained 31% of the variance in the sleep quality of these patients.

Conclusion.  Patients with heart failure should be taught sleep hygiene and to increase leisure time activities, disease self-management, and emotional adjustment skills to improve their sleep quality. These patients should also be observed for night time safety risk due to nocturia.