Background: Patients with Heart failure (HF) and sleep disordered breathing influence health-related quality of life (HRQOL). However, the objective characteristics of sleep in HF patients which related to HRQOL remain unclear. Objectives: This study is to identify and correlates quality of sleep and related factors in patients with HF in Taiwan. Methods: Adult patients (aged ≥20 years) with a current diagnosis of Heart failure, who voluntarily elected (n=200), were evaluated within single medical center. This study was a cross-sectional study based on consecutive hospitalized HF patients in Cathay General Hospital, Taiwan. HRQOL was assessed by using the Pittsburgh sleep Quality Index (PSQI). The cut-off point for PSQI score ≤ 5 were defined as good sleep quality. Results: Seventy-two percent of patients (n =144) reported poor sleep quality (PSQI > 5) at baseline with a mean global PSQI score of 8.48. Also, a significant relationship was found between PSQI scores and patients’ age (p<0.05), Comorbidity (p< 0.01), NHYA class (p< 0.01), Marital status (p< 0.03). When covariates of age, gender, BMI, left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) functional class were entered, Multivariate logistic regression for sleep quality showed that New York Heart Association (NYHA) class IV heart disease was still a significant risk factor (odds ratio=2.31, 95% confidence interval, 1.38-3.88). Moreover, the score of each component of PSQI might increase as NYHA class worsens. Conclusions: The NHYA class IV was the most significant factor for sleep quality in HF patient.