Sleep quality and physical activity profiles associated with quality of life, self-rated health, and happiness: A cross-sectional population study in Western Iran

Abstract

Objectives Although the benefits of a healthy lifestyle are well recognized, little is known about how sleep and physical activity patterns jointly relate to multiple well-being outcomes – namely quality of life, self-rated health, and happiness. This study was designed to address that gap. Methods A cross-sectional survey was conducted across five western provinces of Iran (in october 2024), involving 1187 residents aged 16 years and older. A person-centered cluster analysis was applied to explore the combined associations of sleep quality and physical activity behaviors with the three outcome measures. Results Significant differences emerged among clusters for all outcomes (p < 0.01). Cluster 3 consistently reported the highest mean scores for quality of life (3.57 ± 0.88), self-rated health (4.05 ± 0.76), and happiness (2.38 ± 0.82). Effect sizes were 0.15, 0.19, and 0.10, respectively – large for quality of life and self-rated health, and medium-to-large for happiness. Conclusion Overall, the findings indicate that specific configurations of sleep quality and physical activity are meaningfully linked to well-being indicators. However, given the cross-sectional design, causal inferences cannot be drawn. The results nonetheless offer valuable insights for future research and for tailoring health interventions to population subgroups.