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health-related quality of life, heart failure, sleep disturbance



  1. Chen, Hsing-Mei
  2. Clark, Angela P.
  3. Tsai, Liang-Miin
  4. Chao, Yann-Fen C.


Background: Western research studies have found that sleep disturbances reduced quality of life and daily functioning of patients with heart failure; however, information about sleep disturbance is lacking in Taiwanese people with heart failure.


Objectives: The objective of this study was to investigate predictors of self-reported sleep disturbances in Taiwanese people with heart failure. The hypothesis was that health-related quality of life (HRQOL) could have significant effect on sleep disturbances, after controlling for demographics, heart failure characteristics, and health-related characteristics.


Methods: A cross-sectional, descriptive, correlational design was used. A purposive sample of 125 participants was recruited from the outpatient departments of two hospitals located in southern Taiwan. Participants were interviewed individually to complete the Pittsburgh Sleep Quality Index, Kansas City Cardiomyopathy Questionnaire, Charlson Comorbidity Index, and Perceived Health Scale instruments.


Results: Self-reported sleep disturbances were prevalent (74%) among people with heart failure in Taiwan. Five predictors were identified using hierarchical multiple regression analyses with forward methods, accounting for 26.9% of variance in sleep disturbances. They were education, New York Heart Association functional classification, perceived health, HRQOL social functioning, and physical symptoms. After controlling for demographics, heart failure characteristics, and health-related characteristics, the analysis showed that two variables of HRQOL accounted for 9.8% of the variance in sleep disturbances.


Discussion: The importance of ongoing screening for sleep disturbances in people with heart failure is highlighted based on the study findings about the prevalence of sleep disturbances among the participants in this study. Healthcare providers must understand the often multifactorial nature of sleep disturbances to achieve a better and more effective management.