Insomnia is a modifiable cardiovascular risk factor. Previous studies suggested that attending a cardiac rehabilitation program may improve sleep quality in cardiac patients and pointed out the association between heart failure and poor sleep quality. The primary aim of this study was to evaluate sleep quality in patients attending a Multidisciplinary Cardiac Rehabilitation Program (MRCP), and to compare sleep quality between patients with and without heart failure. A prospective observational study was carried out on a consecutive sample of 240 patients attending an 8-week MRCP; 50 patients (20.8%) were included due to heart failure (NYHA stages I–III) and the rest of them after having undergone any revascularization procedure or valvular surgery. Before and after the completion of the MRCP, the quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI) score. Post-intervention global PSQI scores were statistically significantly lower than those of pre-intervention (p = 0.008), but only 60 patients (25%) registered a clinically significant improvement. When comparing patients with heart failure with those without, no differences in sleep quality were found. This suggests that only a small percentage of patients can achieve clinically significant improvements in sleep quality attending conventional MCRP. Suggestions for future research are given.

Sleep disorders are very common in patients with heart disease. The objective of this study has been to assess the effects of a cardiac rehabilitation program on sleep quality, quality of life, anxiety, depression and functional capacity in patients with heart disease. A pre-test/post-test design study was carried out on the 240 patients included in the cardiac rehabilitation program at the “Virgen de la Victoria” hospital in Malaga; 50 patients (20.8%) were included in the program due to heart failure (HF) and the rest of them after having undergone a revascularization procedure or a surgery for valvular disease. The patients underwent a cardiac rehabilitation program for 8 weeks, based on programmed physical training, health education and psychological treatment. At the end of the program, scores improved on the Pittsburgh Sleep Quality Index (p = 0.008), the SF-36 Quality of Life Questionnaire (p <0.001), the Goldberg Anxiety and Depression Scale (p <0.001) as well as in functional capacity (p <0.001). When comparing patients with heart failure with those without, no differences were found in sleep quality, quality of life, anxiety or depression. In conclusion, the completion of an 8-week cardiac rehabilitation program may improve, in the short term, the quality of sleep in patients with heart disease.