Sleep Quality in Heart Failure Patients: A Systematic Review of Risk Factors and Assessment Tools.

Background: Poorly sleeping is a common problem for heart failure patients and can significantly decrease their quality of life. Among heart failure patients, the widespread issue of poor sleep quality can lead to a diminished quality of life. The present study aimed to review systematically the evidence focused on the determinants of sleep quality factors in heart failure patients. Methods: We conducted a comprehensive search for observational studies in both English- and Persian-language databases from Feb 1991 to Jan 2023. The search strategy included keywords such as "sleep quality" and "heart failure" and risk factors. All screening and extraction steps were carried out by two researchers. Results: The initial search yielded 10,357 articles. After screening, 37 studies (30 cross-sectional studies, 1 longitudinal study, 2 correlational studies, 1 prospective observational study, 2 case-control studies and 1 descriptive-analytical study) were included. We categorized the identified factors as demographic, habits and lifestyle, medication use, and psychological. The Pittsburgh Sleep Quality Index (PSQI) is the most commonly used sleep quality assessment tool. Conclusion: Mental health-related and lifestyle factors such as depression, fatigue, female sex, and high BMI play important roles in disrupting sleep quality. In addition, it is necessary to develop new assessment tools for sleep quality specified for HF patients.