Quality of Life and Sleep Disturbances in Afghanistan: A Large Cross- Sectional Survey Study

Background Sleep and quality of life are closely related to one another in patients as well as in the general population of all age groups. Main objective of this study was to study the prevalence and relationship between sleep disturbance and quality of life among adults in different provinces of Afghanistan. Methods This cross-sectional study was conducted from September 5, 2023 to February 10, 2024 among 1380 adult participants (age range 18–80 years) of eight provinces in southern, western, and northern regions of Afghanistan. Quality of life was evaluated with 26-item Dari version of the World Health Organization's Quality of Life–Bref (WHOQOL-Bref 26) while quality of sleep was assessed with Pittsburgh Sleep Quality Index (PSQI). For data analysis, descriptive statistics, chi-square test, and multiple regression analysis were used. Results Among the 1380 study participants, 68.9% were females, 62.1% were in age group 18–29 years, and 69.1% had experienced a bad event in the past month. Sleep disturbance was present in 50.7% (700/1380) people with mean PSQI global score of 6.13 which showed poor sleep quality among the study participants. In physical, psychological, social relationship, and environmental domains of quality of life, 19.1%, 27.6%, 22.6%, and 26.2% of the study participants had low quality of life. Based on participants’ quality of life, statistically significant sleep disturbance was observed among study participants who had poor quality of life, were very dissatisfied from their health, had high physical domain, high psychological domain, high social relationship domain, and high environment domain. Multiple logistic regression analysis showed that main factors associated with increased sleep disturbance among the study participants were age group 30–80 years ( p -value 0.001), widowed or divorced ( p -value 0.003), people with low family income ( p -value < 0.001), and those who had experienced a bad event in the past month ( p -value 0.001). Conclusion The findings of this study indicate that poor sleep quality is highly prevalent among the general population in Afghanistan, adversely impacting their quality of life. Future research on quality of life should account for sleep quality as a contributing factor. Additionally, well-designed prospective studies examining the correlation between PSQI scores and quality of life could facilitate the development of effective interventions aimed at enhancing quality of life.