Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Predictors of Poor Sleep Quality in Heart Failure Patients: A Cross-Sectional Multivariable Analysis of Clinical, Demographic, and Psychosocial Factors Publisher Pubmed



S Najdaghi SOROUSH ; Dn Davani Delaram NARIMANI ; D Shafie DAVOOD
Authors

Source: Journal of Research in Health Sciences Published:2025


Abstract

Background: Sleep quality is crucial in heart failure (HF) patients, yet its associations with clinical, demographic, and psychosocial factors remain underexplored. This study examined these relationships to identify predictors of poor sleep quality. Study Design: A cross-sectional study. Methods: This cross-sectional was conducted on 354 HF patients at Shahid Chamran Heart Hospital, Isfahan, Iran (September 2023-2024). Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate sleep quality, anxiety, and depression, respectively. Random forest (RF) modeling and ordinary least squares (OLS) regression identified predictors of poor sleep quality. Results: Poor sleep quality (PSQI > 7) was observed in 18% of patients who were older (70.00 ± 6.30, P < 0.001) and had lower ejection fraction (EF) (23.75 ± 12.79%, P < 0.001). This group also had higher systolic blood pressure (BP 140.67 ± 12.50 mmHg, P = 0.014). Complex medication regimens, including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and diuretics, were associated with poor sleep (P < 0.001). Moreover, depression (HADS-depression: 5.36 ± 0.70, P < 0.001) and anxiety (HADS-anxiety: 4.84 ± 1.32, P < 0.001) were correlated with poor sleep. The RF model had an area under the curve of 0.79, and OLS regression (R² = 0.280) highlighted New York Heart Association (NYHA) class and medication type as significant predictors. Conclusion: Overall, poor sleep quality in HF patients was related to older age, reduced cardiac function, higher blood pressure (BP), complex medication regimens, and increased anxiety and depression. Accordingly, multidimensional management strategies are needed to improve sleep outcomes. © 2025 Elsevier B.V., All rights reserved.
Related Docs
View other Related Docs
1. Sleep and Frailty Risk: A Systematic Review and Meta-Analysis, Sleep and Breathing (2020)
2. The Relationship Between Sleep Quality and Work Ability Among the Employees of Isfahan University of Medical Sciences, Iran, in Year 2017, Journal of Isfahan Medical School (2019)
3. Association of Macronutrient Intake, Physical Activity, Anxiety, and Depression With Sleep Quality Among Iranian Male Adolescents, BMC Research Notes (2024)
Experts (# of related papers)
View all Related Experts
Babak Amra (5)
Jamshid Najafian (2)
Other Related Docs
4. The Association of Sleep Duration and Quality With Heart Rate Variability and Blood Pressure, Tanaffos (2020)
5. Effect of Melatonin on Left Ventricular Function in Patients With Heart Failure, Journal of Isfahan Medical School (2011)
6. Hypoxic Burden Based on Automatically Identified Desaturations Is Associated With Adverse Health Outcomes, Annals of the American Thoracic Society (2023)
7. Assessment of Physical Activity and Sleep Disorders in Non-Medical Students, Journal of Isfahan Medical School (2017)
8. Sleep Quality in Patients With Parkinson's Disease, Journal of Isfahan Medical School (2012)
9. Effect of Mindfulness-Based Stress Reduction (Mbsr) Program on Depression, Emotion Regulation, and Sleep Problems: A Randomized Controlled Trial Study on Depressed Elderly, BMC Public Health (2024)
10. Determination of the Incidence of Cardiovascular Composite Events in Patients With Obstructive Sleep Apnea: A 3-Year Follow-Up Study, ARYA Atherosclerosis (2023)
11. The Relation Between Sleep Disorders and Academic Performance in Secondary School Students, Journal of Isfahan Medical School (2012)
12. The Effects of Alcoholic Extract of Saffron (Crocus Satious L.) on Mild to Moderate Comorbid Depression-Anxiety, Sleep Quality, and Life Satisfaction in Type 2 Diabetes Mellitus: A Double-Blind, Randomized and Placebo-Controlled Clinical Trial, Complementary Therapies in Medicine (2018)
13. Association Between Sleep Duration and Electrocardiographic Ischemic Changes in Middle-Aged Population: Isfahan Healthy Heart Program, ARYA Atherosclerosis (2018)
14. The Association Between Quality and Quantity of Carbohydrate With Sleep, Mood, Anxiety, Depression and Stress Among Elderly, BMC Geriatrics (2025)
15. Association Between Sleep Duration and Hypertension Incidence: Systematic Review and Meta-Analysis of Cohort Studies, PLoS ONE (2024)
16. Tea Consumption, Cardiovascular Diseases Risk Factors, Sleep and Mental Health Status Among Diabetic Women, Journal of Diabetes and Metabolic Disorders (2025)
17. Sleep Quality in Patients on Maintenance Hemodialysis and Peritoneal Dialysis, International Journal of Preventive Medicine (2013)
18. Continuous Positive Airway Pressure Treatment for Sleep Apnea in Elderly Patients Systematic Review and Meta-Analysis, Sleep and Breathing (2025)
19. Sleep Quality in Women With Systemic Lupus Erythematosus: Contributing Factors and Effects on Health-Related Quality of Life, International Journal of Rheumatic Diseases (2016)
20. Effect of One-Shot Cognitive Behavioral Therapy on Insomnia and Heart Rate Variability of Health Care Workers at the Time of Covid-19 Pandemic: A Randomized Controlled Trial, Sleep and Breathing (2023)