Sleep Disturbances in Patients with Chronic Heart Failure: A Cross-Sectional Study on Prevalence and Correlates from Bio-Psycho-Social Perspectives

XIAO Yuan; LI Dongya; ZHU Yunlong; WANG Yingchun; HU Liyu; LONG Weijun; LI Fenwei

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Journal of Hunan Normal University(Medical Science) ›› 2026, Vol. 23 ›› Issue (1) : 106-114.

Sleep Disturbances in Patients with Chronic Heart Failure: A Cross-Sectional Study on Prevalence and Correlates from Bio-Psycho-Social Perspectives

XIAO Yuan^1,2, LI Dongya¹, ZHU Yunlong², WANG Yingchun², HU Liyu², LONG Weijun², LI Fenwei²

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Abstract

Objective To investigate the prevalence of sleep disturbances in patients with Chronic Heart Failure (CHF) and analyze their correlations with biological, social, and psychological multidimensional factors, thereby providing a basis for clinical intervention. Methods A retrospective cross-sectional study was conducted. A total of 396 CHF patients admitted to the Department of Cardiology, Xiangtan Second People's Hospital between March 2023 and March 2025 were enrolled. Sleep quality, somatic perception, anxiety/depression status, social support, and family function were assessed using the Pittsburgh Sleep Quality Index (PSQI), Heart Failure Somatic Perception Scale (HFSPS), Hospital Anxiety and Depression Scale (HADS), Social Support Rating Scale (SSRS), and Family APGAR Index, respectively. Patients were divided into a sleep disturbance group (PSQI≥7) and a non-sleep disturbance group (PSQI<7). General patient data and clinical characteristics were collected. Univariate analysis, multivariate Logistic regression, and mediation effect analysis were performed. Results Among the 396 CHF patients, 282(71.21%) had sleep disturbances. Univariate analysis showed that age, self-rated health, New York Heart Association (NYHA) functional classification, SSRS score, Family APGAR score, and HFSPS score were significantly associated with sleep disturbances. Multivariate analysis further indicated that poor self-rated health (OR=3.485, 95% CI: 2.155-5.788) was an independent risk factor for sleep disturbances, while higher family support (OR=0.869, 95% CI: 0.780-0.965) was a protective factor. Mediation analysis revealed that self-rated health played a complete mediating role in the relationship between NYHA classification and sleep disturbances, indicating a suppression effect. Conclusion The incidence of sleep disturbances is high among CHF patients. Their occurrence is closely related to self-rated health and family support, with self-rated health being a key mediator through which objective cardiac function affects sleep. In clinical nursing practice, emphasis should be placed on assessing and providing psychological guidance regarding patients' subjective health perceptions, as well as strengthening the family support system, to improve patients' sleep quality.

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chronic heart failure / sleep disturbance / self-rated health / psychosocial factors

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XIAO Yuan, LI Dongya, ZHU Yunlong, WANG Yingchun, HU Liyu, LONG Weijun, LI Fenwei. Sleep Disturbances in Patients with Chronic Heart Failure: A Cross-Sectional Study on Prevalence and Correlates from Bio-Psycho-Social Perspectives[J]. Journal of Hunan Normal University(Medical Science). 2026, 23(1): 106-114

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