Abstract
BACKGROUND: Headaches, sleep disturbances, and hypertension are common and interrelated conditions that significantly affect quality of life. This study aimed to assess the prevalence and sociodemographic predictors of these conditions among non-psychotic patients in Afghanistan. METHODS: A prospective cross-sectional survey was conducted from September 5, 2024, to September 1, 2025, in Herat province (N = 875). Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI), with scores ≥ 5 indicating poor sleep quality. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Headache was defined as the presence of any clinically diagnosed headache type. Multivariable logistic regression models were used to identify independent predictors of sleep disturbances, hypertension, and headache. RESULTS: Poor sleep quality was reported by 72.7% of participants, and 54.7% met criteria for hypertension. Female sex, widowhood, and rural residency predicted poor sleep quality. Older age (≥ 36 years), widowhood, smoking, and sleep disturbance were independent predictors of hypertension. Female sex and widowhood were significant predictors of headache, with widowed individuals showing the highest odds across all three conditions. CONCLUSION: Sleep disturbances, hypertension, and headaches were highly prevalent in this Afghan clinical population. Older age, female gender, widowhood, and smoking emerged as key predictors, with widowhood representing the strongest vulnerability factor. Targeted interventions addressing psychosocial stress, sleep quality, and cardiovascular risk in socioeconomically disadvantaged groups-particularly widows-are urgently needed.