• Kyoung Suk Lee, Terry A Lennie, Seongkum Heo, Eun Kyeung Song, and Debra K Moser.
• Kyoung Suk Lee is an assistant professor, College of Nursing, Chungnam National University, Dea Jeon, South Korea. Terry A. Lennie is a professor and associate dean, PhD studies, University of Kentucky, College of Nursing, Lexington, Kentucky. Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Eun Kyeung Song is an assistant professor, Department of Nursing, College of Medicine, University of Ulsan, Ulsan, South Korea. Debra K. Moser is a professor, the Gill Endowed Chair of Nursing, and the codirector, RICH Heart Program, University of Kentucky, College of Nursing. kslee14@cnu.ac.kr.
• Am. J. Crit. Care. 2016 Nov 1; 25 (6): 516-525.

BackgroundPoor sleep quality is common and is associated with poor quality of life and health status in patients with heart failure. However, few investigators have focused on the impact of impaired sleep quality on survival in heart failure.ObjectiveTo examine whether self-reported sleep quality is associated with prognosis in patients with heart failure.MethodsThe study sample consisted of 204 patients with heart failure. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Poor sleepers were defined as patients with scores greater than 5 on the index. Patients were followed up for a median of 364 days to determine cardiac events (a composite of cardiac death, hospitalizations, or emergency department visits for cardiac reasons). Multivariable Cox proportional hazard regression was used to examine whether poor sleepers were at a higher risk than good sleepers for shorter cardiac event-free survival after covariates were adjusted for.ResultsOf 204 patients, 129 (63%) reported poor sleep quality. Poor sleepers were 2.5 times more likely to have a shorter cardiac event-free survival (95% CI, 1.164-5.556) than were good sleepers after covariates were controlled for.ConclusionsImpaired sleep quality was prevalent in patients with heart failure and was associated with poor cardiac event-free survival. Clinicians should assess and manage sleep quality in patients with heart failure to improve outcomes.©2016 American Association of Critical-Care Nurses.

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