Key result
Sleep hygiene program improves heart failure self-care scores by ~14 points vs. usual care.
Why the study?
Sleep disorders in HF patients cause cognitive impairment, daytime fatigue, and loss of energy, while daily self-care activities are important for reducing symptoms and improving quality of life. This study aimed to investigate the effect of implementing a sleep hygiene program on HF patients' self-care behavior.
Does implementing a 5-week sleep hygiene program improve self-care behavior in patients with NYHA class II-III heart failure and sleep disorder?
RCT (n=74)
Open-label (data analyst blinded)
Simple randomization (1:1 ratio) using Kitset software with sequentially numbered, opaque, sealed envelopes
No
Does implementing a 5-week sleep hygiene program improve self-care behavior in patients with NYHA class II-III heart failure and sleep disorder?
Implementing a 5-week structured sleep hygiene program significantly improved self-care behaviors in patients with NYHA class II-III heart failure compared to routine discharge education.
Supports integrating sleep hygiene programs into HF self-care; extends behavioral intervention evidence in NYHA II-III patients.
Sleep disorder is the common problems among heart failure (HF) patients, which causes cognitive impairment, day-time fatigue and loss of energy to do their daily activities. Moreover, performing daily self-care activities is considered an important factor for reducing disease symptoms and improving heart failure patients’ quality of life. The present study aims to investigate the effect of implementing sleep hygiene program on HF patients’ self-care behavior. In this randomized controlled trial, 74 heart failure patients (NYHA class II–III) from Qaem Hospital, Firoozabad, were randomly allocated (1:1) to intervention ( n = 37) or control ( n = 37) groups using simple randomization by Kitset software. Allocation was concealed using sequentially numbered, opaque, sealed envelopes.. The intervention group received five 90-min sessions of sleep hygiene program on a weekly basis in person and virtually using a sleep hygiene self-declaration booklet. Demographic questionnaire and valid and reliable heart failure self-care behavior scale were used to collect the data. The data were collected in two steps, before and after the intervention. The data were analyzed by SPSS 21.0 using independent t-tests, paired t-tests, their non-parametric equivalents (Wilcoxon and Mann-Whitney tests), and a one-way analysis of covariance (ANCOVA). No significant baseline differences existed between groups. In the intervention group, self-care behavior significantly improved post-intervention (Wilcoxon, p < 0.001), while the control group showed significant worsening (paired t-test, p < 0.001). Between-group comparison (Mann-Whitney, p < 0.001) favored the intervention. ANCOVA, adjusting for baseline scores, confirmed a significant main effect (F (1, 70) = 4.110, p = 0.046, η²=0.055), with a mean difference of –13.51 (95% CI: –15.27 to –11.75, p < 0.001). Most individual self-care items improved significantly except daytime rest and flu vaccination ( p > 0.05). Implementing the sleep hygiene program improved HF patients’ self-care behavior. Therefore, it is suggested that nurses and managers at medical centers use the sleep hygiene program in order to improve HF patients’ self-care. IRCT20231030059902N1- Registration Date: 2024/01/20- https://irct.behdasht.gov.ir
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Badiyepeymaiejahromi et al. (2026) conducted an RCT in Heart failure (NYHA class II-III) with sleep disorder (n=74). Sleep hygiene program vs. Usual care (routine hospital discharge education) was evaluated on Post-intervention European Heart Failure Self-Care Behavior Scale (EHFScBS) score (range 12-60; lower scores indicate better self-care) (MD -13.51, 95% CI -15.27 to -11.75, p=<0.001). A 5-week sleep hygiene program significantly improved self-care behavior scores in heart failure patients compared to usual care (MD -13.51, 95% CI -15.27 to -11.75, p<0.001).
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