Effect of a Structured Nursing Intervention Incorporating Sleep Hygiene and Cognitive-Behavioral Strategies on Sleep Quality Among Patients With Chronic Heart Failure

Chronic heart failure is a progressive cardiovascular condition that is frequently accompanied by sleep disturbances, including insomnia, fragmented sleep, and poor sleep quality. These sleep problems contribute to fatigue, impaired daily functioning, poor self-care, and reduced health-related quality of life. Although pharmacological treatment is essential for heart failure management, non-pharmacological interventions such as sleep hygiene education and cognitive-behavioral strategies have shown promise in improving sleep outcomes.

This study will evaluate the effectiveness of a structured nursing intervention that integrates sleep hygiene education with cognitive-behavioral strategies for improving sleep quality among patients with chronic heart failure. The intervention will be delivered by trained nurses through structured educational sessions and individualized counseling.

The sleep hygiene component includes education on maintaining a regular sleep schedule, optimizing the sleep environment, limiting caffeine and stimulating activities before bedtime, promoting physical activity appropriate to the patient's condition, and establishing healthy bedtime routines. The cognitive-behavioral component includes relaxation techniques, cognitive restructuring of maladaptive beliefs about sleep, stimulus control, and behavioral strategies to reduce sleep-related anxiety.

Participants will be assessed at baseline before the intervention and at predetermined follow-up intervals after completion of the program. The primary outcome is sleep quality measured using a validated sleep assessment instrument. Secondary outcomes may include fatigue, quality of life, daytime functioning, and adherence to recommended sleep practices. The findings of this study are expected to support the integration of evidence-based nursing interventions into routine care for patients with chronic heart failure to improve sleep and overall well-being.

Inclusion criteria

• Adult patients aged 18 to 65 years.
• Diagnosed with chronic heart failure for at least 6 months according to the New York Heart Association (NYHA) classification.
• Experiencing poor sleep quality as indicated by a score >5 on the Pittsburgh Sleep Quality Index during the previous month.

Exclusion criteria

• Patients with diagnosed psychiatric disorders or severe cognitive impairment.
• Patients receiving sedative-hypnotic therapy initiated within the previous month.
• Patients diagnosed with obstructive sleep apnea requiring continuous positive airway pressure therapy.
• Patients participating in other behavioral intervention program