title: Sleep quality and associated factors among patients with chronic heart failure in Iran.
abstract: BACKGROUND
  Sleep disorders are common among patients with chronic heart failure (HF), and it can have a significant effect on patients' daily activities as well as their health. The purpose of this study was to assess sleep quality and its predictors in Iranian patients with chronic HF.
  
  
  METHODS
  This cross-sectional study was conducted on a sample of 200 patients with HF in two hospitals of Tehran University of Medical Sciences from June to November 2009. These patients completed a demographic questionnaire, and their sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). One-way analysis of variance (ANOVA), Kruskal-Wallis test, t-test and Linear regression were used for data analysis.
  
  
  RESULTS
  Seventy-nine percent of patients (n = 158) reported poor sleep quality (PSQI > 5). The range of global PSQI scores was 3-20. Also, a significant relationship was found between PSQI scores and patients' age (p<0.004), gender (p< 0.042), educational level (p< 0.001), occupational status (p< 0.038), number of hospitalizations (p< 0.005), type of referral (p< 0.001), non-cardiac diseases (p< 0.001), diuretic use (p< 0.021) and left ventricular ejection fraction (p< 0.015). Three predictors were identified using regression analyses with stepwise methods, and included age, type of referral and educational level.
  
  
  CONCLUSIONS
  The high prevalence of poor sleep quality highlighted the importance of sleep disorders in HF patients. There are many factors associated with sleep quality and sleep disorders that health providers should recognize for improved and effective management.
authors.affiliation: 1. BSc, MSc in Nursing, Teacher in School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran. m.moraditeacher@gmail.com.
authors.forename: Mina
authors.initials: M
authors.lastname: Moradi
authors.affiliation: 2. MSc, PHD in Nursing, Associate Professor, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences & Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran. nmehrdad@tums.ac.ir.
authors.forename: Neda
authors.initials: N
authors.lastname: Mehrdad
authors.affiliation: 3. BSc, MSC in Nursing, Assistant Professor, Center for Nursing Care Research, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran. s-nikpour@iums.ac.ir.
authors.forename: Soghra
authors.initials: S
authors.lastname: Nikpour
authors.affiliation: 4. MSc in Biostatistics. Faculty Member School of Public Health, Iran University of Medical Sciences, Tehran, Iran. haghani511@yahoo.com.
authors.forename: Hamid
authors.initials: H
authors.lastname: Haghani
authors.affiliation: 5. BSc in Nursing, MSc in Medical Education, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. maryam_aalaa@yahoo.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Aalaa
authors.affiliation: 6. Sc, MSc. PhD Student in Nursing, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute. Tehran University of Medical Sciences, Tehran, Iran. sanjarim@yahoo.com.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Sanjari
authors.affiliation: 7. MD, PhD by research Students, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences & Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. sharifi.tums.ac@gmail.com.
authors.forename: Farshad
authors.initials: F
authors.lastname: Sharifi
keywords: Heart Failure; Sleep Disorder; Sleep Quality