Is happiness the strongest predictor of sleep quality? A study on physical activity, stress, and health in Uzbekistan.

OBJECTIVE: Aim: To identify key predictors of sleep quality among adults in Uzbekistan, with a focus on health-related factors such as physical activity, psychological well-being (happiness, stress, loneliness), and self-rated health status. The research addresses a critical and growing public health issue in transitional societies, where sleep disturbances remain underexplored despite their widespread impact on overall health and well-being. PATIENTS AND METHODS: Materials and Methods: A cross-sectional survey was conducted online in June 2024 among 450 adults aged 18 and older from various regions of Uzbekistan. Sleep quality was assessed using a 5-point Likert scale. Independent variables included physical activity, happiness, stress, loneliness, and health status. Ordinal logistic regression was applied, controlling for socio-demographic characteristics. RESULTS: Results: Happiness (OR = 1.812, p < 0.001) and physical activity (OR = 1.293, p = 0.045) were significantly associated with better sleep quality, while stress (OR = 0.833, p = 0.026) and poor health (OR = 0.526, p < 0.001) predicted lower sleep quality. Subgroup analysis confirmed that age and gender modulate these associations, with happiness remaining the strongest and most consistent predictor. CONCLUSION: Conclusions: These findings highlight the pivotal roles of emotional well-being, lifestyle, and health in shaping sleep quality. Public health strategies should incorporate mental wellness, physical activity, and stress management to improve population-level sleep outcomes in Uzbekistan and similar socio-cultural contexts.