Thesis (Ph.D.(Nursing))-- Chulalongkorn University, 2009

This descriptive research was designed to explore the characteristics of insomnia in persons with heart failure and examine the relationships among the predisposing factors, the precipitating factors, the perpetuating factors and insomnia. Three hundred and forty heart failure patients, who were followed-up at heart clinic at 10 tertiary hospitals in Thailand, were selected by multi-stage random sampling. Data were collected during July 2009 – January 2010. Research instrument included demographic questionnaire, state-trait anxiety inventory questionnaire, Center for epidemiologic studies depression scale, dyspnea questionnaire, Berlin questionnaire, New York Heart Association functional classification, sleep hygiene awareness and practice scale, dysfunctional beliefs and attitudes about sleep and insomnia severity index. Data were analyzed by using descriptive statistic, Chi-square test, and logistic regression. The result of the study revealed that there were thirty-two percent of heart failure patients had insomnia. Twenty-three point eight percent had moderate insomnia and 8.2 % had severe insomnia. The most common type of insomnia was difficulty falling asleep and difficulty staying asleep. Correlated factors of insomnia including the predisposing factors: anxiety and depression, the precipitating factors: marital status, dyspnea, sleep disorder breathing and functional status, and the perpetuating factors: sleep hygiene and dysfunctional beliefs and attitudes about sleep. After using logistic regression analysis found that the predictive factors of insomnia were anxiety, depression, marital status, dyspnea, and dysfunctional beliefs and attitudes about sleep