1
|
Nakie G, Takelle GM, Rtbey G, Andualem F, Tinsae T, Kassa MA, Tadesse G, Fentahun S, Wassie YA, Segon T, Kibralew G, Melkam M. Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study. Front Psychiatry 2024; 15:1370757. [PMID: 38559402 PMCID: PMC10979362 DOI: 10.3389/fpsyt.2024.1370757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.
Collapse
Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Aldhafiri A, Almutairi N, Alharbi M, Aloufi A, Hakeem A, Kattan A, Alzahrani F. Evaluation of Sleep Behavior and the Use of Sleep Aids among Adults Living in Saudi Arabia: A Cross-Sectional Study. Clocks Sleep 2023; 5:536-551. [PMID: 37754353 PMCID: PMC10528987 DOI: 10.3390/clockssleep5030035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/30/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
A negative attitude toward sleep has greatly affected sleep habits. In addition to contributing to physical and metabolic disorders, poor sleep quality may cause emotional disturbances. This study aimed to measure sleep behavior and factors contributing to poor sleep quality in the Madinah region, Saudi Arabia. We also assessed whether the use of sleeping aids improved peoples sleep. Three hundred and ninety-nine adults in the Madinah region of Saudi Arabia participated in this cross-sectional study. Three data domains were collected using an online questionnaire between 30 January and 26 April 2022. In the first domain, the characteristics of participants were discussed. In the second domain, questions about sleep behavior were asked. In the third domain, we examined the types, frequency, and impact of sleep aid use. Out of the 399 participants, 154 (38.59%) reported sleep problems. A total of 64.94% of the 154 participants blamed stress as the leading cause of their sleep disorders, and 74.68% of those with sleep problems reported reduced productivity. Among those who reported having sleep problems, 46.10% used sleep aids, with Panadol night (antihistamine) being the most used, 49.30%, followed by Melatonin at 39.44%. Sleep quality improved by 67.6% among those who used sleep aids. A total of 71.8% of the participants think it is not safe to use sleep aids in the long term. Our findings suggest that sleep problems are a prevalent concern in Madinah, Saudi Arabia, and even though the use of sleep aids improved sleep quality, it should be considered an emerging and important public health objective in Saudi Arabia. Further studies are needed to evaluate sleep quality and the level of sleep aid usage among other Saudi Arabian regions.
Collapse
Affiliation(s)
- Ahmed Aldhafiri
- Pharmacology and Toxicology Department, College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Nawaf Almutairi
- College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Mohammed Alharbi
- College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Abdullah Aloufi
- College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Abdulaziz Hakeem
- College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Abdulmalik Kattan
- College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| | - Fahad Alzahrani
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah al-Munawara 42353, Saudi Arabia
| |
Collapse
|
3
|
Öner Ö, Ecevit MC, Gökmen AN. A bibliometric analysis of obstructive sleep apnea and anesthesia. Medicine (Baltimore) 2023; 102:e32993. [PMID: 37115083 PMCID: PMC10145860 DOI: 10.1097/md.0000000000032993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
To conduct a bibliographic analysis of obstructive sleep apnea (OSA) which has reached epidemic proportions and is a frequent, unknown, and important cause of perioperative morbidity and mortality, by examining the internationally most cited articles. For OSA, the most cited articles in the field of anesthesiology and reanimation, appropriate access terms were compiled and combined, and related publications were searched using the Thompson Reuters Web of Science Citation Indexing search engine. A total of 79 journal publications were found on OSA and anesthesia, with an average of 14.86 citations per article. The most cited publication was the "Society for Ambulatory Anesthesia Consensus Statement on Preoperative Selection of Adult Patients with Obstructive Sleep Apnea Scheduled for Ambulatory Surgery" published in the journal Anesthesia and Analgesia and was conducted by Joshi et al. It was found that 38 of the 79 studies reached as a result of the search were articles, and the average number of citations was 21.13. The Hirsch index of these articles, which were cited 803 times in total, was 15. A total of 31 articles (81.57%) were cited at least once, while the remaining 7 articles (18.43%) were not cited at all. The majority of the articles obtained are from the research fields of anesthesiology (n = 20; 52.63%), followed by otorhinolaryngology (n = 5; 13.15%), pediatrics (n = 5; 13.15%), respiratory system (n = 5; 13.15%), internal medicine (n = 4; 10.52%), and the rest were in various fields. Publications on "Obstructive Sleep Apnea" and "Anesthesia" have increased rapidly in the last decade. Anesthesia management and airway safety, patient management, including pain control in the postoperative period, and noninvasive mechanical ventilation treatment methods, such as continuous positive airway pressure, are hot topics.
Collapse
Affiliation(s)
- Özlem Öner
- Anesthesiologist, Intensivist and Neuroscience PhD Student, Department of Anesthesiology and Reanimation Subdivision of Critical Care, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Mustafa Cenk Ecevit
- Otolaryngolist, Professor, Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Ali Necati Gökmen
- Anesthesiologist, Intensivist and Biophysics PhD Professor, Department of Anesthesiology and Reanimation Subdivision of Critical Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
4
|
Abedelmalek S, Adam H, Alardan S, Yassin S, Chtourou H, Souissi N. Physical Activity, Sleep Patterns and Diet Habits as Well as the Prevalence of Obesity among Adolescents: A Cross Sectional Study from Ha'il City in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16174. [PMID: 36498248 PMCID: PMC9741398 DOI: 10.3390/ijerph192316174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/17/2023]
Abstract
Obesity is expected to increase in the Kingdom of Saudi Arabia (KSA). Therefore, the objective of this study was to determine the physical activity, sleep patterns and diet habits as well as the prevalence of obesity among adolescents from Ha’il City. A cross-sectional study was conducted with 1598 adolescent students (663 males and 935 females) aged 12−15 years who were randomly selected from different schools in Ha’il. Body mass index (BMI) was used to classify participants as underweight, normal weight, overweight and obese (class and class II). Moreover, physical activity, sleep patterns and diet habits were recorded. The prevalence of obesity was 52.1%. Obesity is significantly more prevalent in females compared to males (62.9% vs. 36.59%, p < 0.001). Moreover, students in the third grade are the most obese in comparison with the first and the second educational level (p < 0.001). Additionally, students aged 15 years old are the most obese compared to 12 years, 13 years and 14 years (p < 0.001). Additionally, the results showed that students who suffer from obesity eat food when they feel higher stress and tension scores and that they do not eat their meals regularly. Additionally, 79% of those who eat fried food daily are obese. It was reported that 61.1% of students in this study were physically inactive. Furthermore, 58.4% of students have a higher proportion of insufficient sleeping duration (>7 h per night) (p < 0.001). This increased rate of obesity is higher in females compared to males and it was related to inactivity as well as perturbed sleep and eating habits. Therefore, we recommend an obesity prevention program including health education in Ha’il City, KSA.
Collapse
Affiliation(s)
- Salma Abedelmalek
- Department of Sport Science and Physical Activity, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Sousse 4002, Tunisia
| | - Halima Adam
- Department of Psychology, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Sultan Alardan
- Department of Sport Science and Physical Activity, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Sami Yassin
- Department of Psychology, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Hamdi Chtourou
- Research Unit Physical Activity, Sport and Health (UR18JS01), National Observatory of Sports, Tunis 1003, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3003, Tunisia
| | - Nizar Souissi
- Research Unit Physical Activity, Sport and Health (UR18JS01), National Observatory of Sports, Tunis 1003, Tunisia
- High Institute of Sport and Physical Education, Ksar-Saïd, Manouba University, Manouba 1003, Tunisia
| |
Collapse
|
5
|
BaHammam AS, Al-Jahdali HH, Alenazi MH, Aleissi SA, Wali SO. Curriculum development for the Saudi sleep medicine fellowship program. J Taibah Univ Med Sci 2022; 17:782-793. [PMID: 36050948 PMCID: PMC9396068 DOI: 10.1016/j.jtumed.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/08/2021] [Accepted: 12/22/2021] [Indexed: 10/31/2022] Open
Abstract
Objectives Given the rapid global development of sleep medicine, well-qualified sleep medicine physicians are necessary to meet the demand. Although sleep medicine was accredited as an independent specialty in KSA in 2012, national data suggest that the number of trained and accredited sleep medicine specialists remains comparatively low. A structured sleep medicine fellowship programme was established in KSA in 2009. However, universities issued training and certification without a national training programme under the auspices of the Saudi Commission for Health Specialties (SCFHS). Therefore, plans have been made to establish a national interdisciplinary sleep medicine training programme to serve the whole country. Methods In 2020, the SCFHS mandated the Specialty Curriculum Development Committee of the Sleep Medicine Fellowship Program to develop the National an adult sleep medicine national program. Results The committee developed an adult sleep medicine fellowship programme curriculum and requirements to ensure that trainees become competent at assessing, diagnosing, and managing various sleep disorders. The curriculum was approved by the head of the Curricula Editorial Board of the SCFHS. Conclusions This paper presents the curriculum and admission requirements for the newly developed Saudi Sleep Medicine Fellowship Program.
Collapse
Affiliation(s)
- Ahmed S. BaHammam
- University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, KSA
- Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, KSA
| | - Hamdan H. Al-Jahdali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Meteb H. Alenazi
- University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, KSA
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, KSA
| | - Salih A. Aleissi
- University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, KSA
| | - Siraj O. Wali
- Sleep Medicine Research Group, Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, KSA
| |
Collapse
|
6
|
Awareness of Medical Students toward Circadian Rhythm and Sleep Disorder Based on Biomedical Diagnosis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8645183. [PMID: 36033578 PMCID: PMC9410799 DOI: 10.1155/2022/8645183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022]
Abstract
Background Sleep disorders affect an individual's mental and physical health and vice versa. Sleep medicine is underrecognized as a specialty; therefore, many sleep disorders go undiagnosed. This study is aimed at assessing the knowledge of medical students toward circadian neuroscience and sleep disorder based on biomedical diagnosis. Methods This cross-sectional study was conducted in both male and female medical colleges from the third to the sixth year. A self-administered structured questionnaire consisting of sociodemographic data and the Assessment of Sleep Knowledge in Medical Education (ASKME) survey assessed the students' general knowledge and attitude towards sleep disorder and sleep medicine. Chi-square/Fisher exact tests were used to analyse the participants' knowledge level toward specific sociodemographic data. Also, for two-level continuous variables, the Wilcoxon two-sample test was used. Results The total number of participants was 296, with 154 female and 142 male participants. The prevalence of inadequate knowledge was considerable with 96.62% of students, compared to adequate knowledge with only 3.38%. The students' attitude to sleep medicine was negative 14.53% and positive among 85.47%. We found that gender was significantly associated with attitude with a p value = 0.0057. The specific interest in sleep medicine had a significant association with knowledge and attitude, p value of 0.0522 and 0.0059, respectively. Conclusion This study concluded that medical students possess inadequate knowledge regarding sleep medicine, yet they have a positive attitude towards it.
Collapse
|
7
|
Lin KY, Eow PY, Kohli S, Math SY. Correlation of Medical Comorbidities and Upper Airway Measurements among Dental Patients at Risk of Developing Obstructive Sleep Apnea. Clin Pract 2022; 12:284-298. [PMID: 35645311 PMCID: PMC9149922 DOI: 10.3390/clinpract12030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
Obstructive Sleep Apnea (OSA) is a partial or total upper airway collapse resulting in sleep-breathing disturbances. There are many medical comorbidities associated with OSA; hence, this study is important as the prevalence of patients with medical comorbidities associated with OSA is increasing. The study aimed to correlate medical comorbidities and OSA symptoms of the patients along with their upper airway dimensions using Cone Beam Computed Tomography (CBCT) scans to identify patients at risk of developing OSA. This cross-sectional study included patients who had CBCT imaging taken between 2014 and 2020. A questionnaire was used to gather information on patients’ medical history and OSA symptoms. The upper airway dimensions of the CBCT scans were evaluated before logistic regression and Fisher’s exact test were carried out to determine the relationships between the variables. p ≤ 0.05 was considered statistically significant. Logistic regression revealed an association of longer length (p = 0.016), smaller total volume (p = 0.017) and width (p = 0.010) of upper airways with hypertension. Furthermore, loud snoring was seen in patients with hypertension, heart disease and obesity whereas difficulty concentrating during the day was present in subjects with deviated nasal septum, tonsillitis and depression. For upper airway dimensions, a smaller average volume was associated with loud snoring (p = 0.037), difficulty concentrating during the day (p = 0.002) and mood changes (p = 0.036). A larger anterior-posterior dimension was also associated with excessive daytime sleepiness (p = 0.042), difficulty concentrating during the day (p < 0.001) and mood changes (p = 0.009). Longer airway length was additionally found to be associated with loud snoring (p = 0.021). CBCT taken for dental investigations could be correlated with patients’ medical history and OSA symptoms to screen patients at risk of OSA.
Collapse
|
8
|
Komolafe MA, Sanusi AA, Idowu AO, Balogun SA, Olorunmonteni OE, Adebowale AA, Fawale MB, Mosaku KS. Sleep medicine in Africa: past, present, and future. J Clin Sleep Med 2021; 17:1317-1321. [PMID: 33687322 DOI: 10.5664/jcsm.9218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
NONE Interest in sleep and sleep disorders in Africa dates back thousands of years, influenced by various cultural and religious beliefs. However, the practice of sleep medicine as a specialty has been inadequate compared to other regions of the world. The objective of this study was to explore the current status of sleep medicine in Africa vis-à-vis education, professional societies, and facilities, and to identify challenges of the specialty in the region. A literature search of major electronic databases (PubMed, Google Scholar) was done. This revealed that there is a high prevalence of sleep disorders in Africa and a significant association with epilepsy, human African trypanosomiasis, human immunodeficiency virus, and other diseases. There are 6 sleep societies in Africa located in 4 countries. Forty-one sleep laboratories were identified located in 4 countries. The challenges hindering development of sleep medicine in Africa include lack of awareness, poor funding, lack of facilities, and inadequate training.
Collapse
Affiliation(s)
- Morenikeji A Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Ahmad A Sanusi
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Ahmed O Idowu
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Simon A Balogun
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Oluwatosin E Olorunmonteni
- Department of Pediatrics and Child Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Akintunde A Adebowale
- Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Michael B Fawale
- Department of Mental Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Kolawole S Mosaku
- Department of Mental Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| |
Collapse
|
9
|
Aljasem AA, Alsahafi WM, Aljubour AA, Alobaid AA, Binsaeed AA, Alshamoosi MS, Alsadoon RA, Alasmari YA, Khalifa AFM. Sleep pattern and dozing chance among university students. J Family Med Prim Care 2021; 9:6249-6253. [PMID: 33681072 PMCID: PMC7928132 DOI: 10.4103/jfmpc.jfmpc_941_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Sleep is defined as a naturally occurring state of the body within a relatively inhibited sensory activity, reduced metabolic rate and decreased interaction with the surrounding. Impaired sleep affects students’ productivity, this area is not fully covered in the literature. Objectives: To assess sleep patterns and dozing chance among university students. Methods: Institutional based cross-sectional study, a sample of 145 male university students from Almaarefa University aged between 19 and 27 years old, chosen randomly. A self-administered questionnaire developed specifically for this study after consulting literature and epidemiologist. It includes data about the Epworth Sleepiness scale and GPA. Data were analyzed using (SPSS, version 22.0) and (P values of ≤0.05) considered significant. The consent was obtained before data collection. Results: The majority of respondents (62, 1%) reported sleeping time of 5-8 hours per night. To fall asleep at night 13, 1% of participants indicated needing soporific. Overall, only 36, 6% of students showed good sleep behaviors. Among respondents (44, 1%) had moderate chances of dozing and 2, 8% had high chances of dozing, There was no significant statistical relationship between academic performance and bedtime (P-value = 0,231). Conclusion: The majority of respondents had poor sleep quality and moderate to high dosing chance, also, most of the participants go to bed after midnight. In addition, one fifth of participants reported sleeping less than 8 hour per day.
Collapse
Affiliation(s)
- Abdullah A Aljasem
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Waseem M Alsahafi
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Ahmad A Aljubour
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Ahmed A Alobaid
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Abdullah A Binsaeed
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | | | - Rsheed A Alsadoon
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Yaser A Alasmari
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Amar F M Khalifa
- Assistant Professor of Community Medicine, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| |
Collapse
|
10
|
BaHammam AS, Han F, Gupta R, Duong-Quy S, Al-Abri MA, Jahrami HA, Song P, Desudchit T, Xu L, Hong SB. Asian accreditation of sleep medicine physicians and technologists: practice guidelines by the Asian Society of Sleep Medicine. Sleep Med 2021; 81:246-252. [PMID: 33735652 DOI: 10.1016/j.sleep.2021.02.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022]
Abstract
Due to the rapid growth in sleep medicine's professional content, several countries have recognized sleep medicine as an independent specialty. The practice of sleep medicine and the demand for this service in Asian countries are expanding. At this point of growth, the accreditation of sleep medicine specialists is paramount to patient care and the training of physicians and technologists. The Asian Society of Sleep Medicine (ASSM) mandated a taskforce committee for the accreditation of sleep medicine practice. This taskforce developed Asian accreditation practice guidelines for sleep medicine physicians and technologists. This paper presents the newly approved Asian accreditation practice guidelines for sleep medicine physicians and technologists by the ASSM.
Collapse
Affiliation(s)
- Ahmed S BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia.
| | - Fang Han
- Sleep Center, Peking University People's Hospital, Beijing, China.
| | - Ravi Gupta
- Department of Psychiatry and Division of Sleep Medicine, All India Institute of Medical Sciences, Veerbhadra Marg, Rishikesh, 249203, India.
| | - Sy Duong-Quy
- Bio-Medical Research Center, Lam Dong Medical College, Dalat, Viet Nam; Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA.
| | - Mohammed A Al-Abri
- Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | - Haitham A Jahrami
- Ministry of Health, Manama, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| | - Pamela Song
- Departments of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea.
| | - Tayard Desudchit
- Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital/The Thai Red Cross Society, Bangkok, Thailand; Division of Neurology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Neurology, Department of Pediatrics, SK Building 11, King Chulalongkorn Memorial Hospital/The Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
| | - Liyue Xu
- Sleep Center, Peking University People's Hospital, Beijing, China.
| | - Seung Bong Hong
- Department of Neurology, Samsung Medical Center, Samsung Biomedical Research Institute (SBRI), Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
11
|
Al Ehaideb AA, Almufadhi NM, Ab Alhassn GM, Fallatah AA, Adnan S, Alsubaie AA. Sleep-disordered breathing among Saudi children seeking orthodontic treatment. J Family Med Prim Care 2021; 10:205-212. [PMID: 34017727 PMCID: PMC8132852 DOI: 10.4103/jfmpc.jfmpc_1918_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/24/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
Aims The aim of this research is to assess the prevalence of sleep disordered breathing (SDB) and evaluate the risks and symptoms in children seeking orthodontic treatment in a Saudi dental center. Settings and Design It is a cross-sectional survey-based study. Methods and Material Pediatric sleep questionnaire (PSQ) was used to survey 285 children and adolescents aged 5 to 18 years old who are undergoing orthodontic screening in a Saudi Dental Center. Statistical Analysis Used PSQ scores were tested with multiple variables including gender, parents' education, academic performance using Mann-Whitney-U test. Correlation of study sample scores with age were calculated using the Spearman rank correlation coefficient (rho). Results In this study 136 (47.7%) of the participants were deemed to be high risk for developing SDB and 149 (52.3%) were low risk, males were significantly at higher risk compared to females (P ≤ 0.05). Participants with previous adenoidectomy surgery were more likely to be identified as high-risk for SDB (P-value = 0.000) as well as participants with a family history of snoring (P-value = 0.000). Conclusions Sleep disordered breathing was prevalent among Saudi children seeking orthodontic therapy, it is important to screen children and adolescents in dental pediatric and orthodontic clinics for SDB risk as this is a prevalent disorder among this population, early detection of SDB will improve patients' quality of life and prevent future complications associated to this disorder.
Collapse
Affiliation(s)
- Ali A Al Ehaideb
- Assistant Professor, Preventive Dental Science Department, College of Dentistry, Qassim University, Saudi Arabia
| | - Norah M Almufadhi
- Dental Intern, College of Dentistry, Qassim University, Saudi Arabia
| | - Ghaida M Ab Alhassn
- General Dental Practitioner, Collage of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Amal A Fallatah
- Dental Intern, Collage of Dentistry, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Shazia Adnan
- Lecturer, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Areej A Alsubaie
- Psychology Specialist, College of Education, Princess Nourah bint Abdulrahman University, Saudi Arabia
| |
Collapse
|
12
|
Alrebdi YM, Awadh AKI, Alfehaid MS, Alsindi AA, Alaraj A. Knowledge and Attitude Regarding Sleep Medicine among Medical Students at Qassim University, Saudi Arabia. Open Access Maced J Med Sci 2019; 7:2895-2901. [PMID: 31844455 PMCID: PMC6901853 DOI: 10.3889/oamjms.2019.833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/28/2019] [Accepted: 07/29/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDS: Sleep disorders and sleep medicine are underrecognized by both the general public and health care workers. Lack of education and training in sleep medicine has resulted in a culture of physicians who have very limited knowledge about sleep disorders and, as a result, are likely to underdiagnose and under-treat patients. AIM: This study aimed to assess the knowledge of and attitude regarding sleep medicine among medical students at Qassim University. METHODS: This was a cross-sectional study of 4th and 5th-year medical students, conducted at Qassim University (Central and Unaizah branches), Saudi Arabia. We used a self-administered data collection tool to collect personal information (age, name, sex, medical school), and assessed general attitude toward sleep medicine and the students’ current knowledge about sleep medicine using the Assessment of Sleep Knowledge in Medical Education (ASKME) survey. RESULTS: The prevalence of medical students who had a special interest in sleep medicine was 23.3%. Poor knowledge about sleep medicine was detected in 94.8% of students, while good knowledge was observed in only 5.2%. The attitude of the students toward sleep medicine was negative among 40.5% and positive among 59.5%. University branches, gender, and preferred speciality were all significantly associated with attitude score, whereas interest in sleep medicine and knowledge of sleep disorders were associated with both knowledge and attitude scores. CONCLUSION: This study found that medical students’ knowledge of sleep medicine was very low, despite the majority of them having a positive attitude toward it.
Collapse
Affiliation(s)
| | | | | | | | - Ali Alaraj
- Pulmonary Medicine, Dr Suliman Alhabib Medical Group, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Almeneessier AS, Al-Jebrin S, Labani R, Alkaff H, Al-Rahbeeni O, Alageel M, Olaish A, BaHammam AS. Medical specialty visits and diagnoses received by Saudi patients prior to a diagnosis of narcolepsy. Sleep Breath 2019; 23:603-609. [PMID: 30820852 DOI: 10.1007/s11325-019-01807-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/09/2019] [Accepted: 02/14/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE Narcolepsy is an uncommon neurological disorder characterized by excessive daytime sleepiness (EDS) and multiple other symptoms. Due to the under-recognition of narcolepsy symptoms, patients are often misdiagnosed. This study aimed to assess the types of specialties visited and the diagnoses received by Saudi patients prior to their narcolepsy diagnosis. METHODS The study included 55 consecutive patients with type-1 and type-2 narcolepsy who attended the narcolepsy clinic between August 2017 and December 2017. Narcolepsy was diagnosed according to the International Classification of Sleep Disorders-third edition criteria. We evaluated sociodemographic data, the specialties visited, and diagnoses and treatments received prior to visiting a sleep specialist. RESULTS The mean diagnostic delay was 9.1 ± 8.4 years (1-43 years). Multiple linear regression analysis identified early onset as the only predictor of a delayed diagnosis (β coefficient = - 0.262, p = 0.03). EDS was the main symptom that prompted patients to seek medical consultation, and only one patient had been (1.8%) referred with the diagnosis of narcolepsy. In the study group, 82% of the patients were misdiagnosed with a mental or neurological disorder or were thought to be afflicted by "envy," "evil eye," or "black magic" before receiving a correct diagnosis. No significant differences were detected between patients with narcolepsy type-1 and narcolepsy type-2. CONCLUSIONS Delays in diagnosing narcolepsy remain a major problem for Saudi patients with this disorder. We found that Saudi patients with narcolepsy had visited several medical specialists and faith healers and were misdiagnosed prior to visiting a sleep specialist.
Collapse
Affiliation(s)
- Aljohara S Almeneessier
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Sara Al-Jebrin
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Reem Labani
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Hussain Alkaff
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Omar Al-Rahbeeni
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Musab Alageel
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Awad Olaish
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia.
| |
Collapse
|
14
|
Current Clinical Practice for the Use of Hypnotics to Manage Primary Insomnia in Adults in a Tertiary Hospital in Saudi Arabia: An Audit Study. PHARMACY 2019; 7:pharmacy7010015. [PMID: 30691097 PMCID: PMC6473234 DOI: 10.3390/pharmacy7010015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 01/06/2023] Open
Abstract
Despite the risks associated with hypnotics and their recent increased use in Saudi Arabia, there are no specific national guidelines for using these medicines to treat insomnia nor are there any data on how these medicines are currently prescribed. There is the potential, however, that some physicians might be adhering to the United States guidelines. The current audit study was aimed to assess the current practice in treating insomnia with hypnotics in Saudi Arabia, and to evaluate its agreement with the US guidelines. The audit was conducted using data collected between April 2012 and March 2017 at King Fahad Central Hospital (KFCH; Jazan), of patients who were either prescribed benzodiazepines (BZDs) or Z-drugs or diagnosed with insomnia. The audit criteria followed two US guidelines for the management of insomnia in adults. Data included documented diagnosis, use of CBT-I (Cognitive Behavioral Therapy for Insomnia), use of BZDs and Z-drugs including treatment regimen, and whether physicians prescribed anti-histamines for insomnia. The data were analyzed using STATA 14 after transcription to a MS XL file. Of the 504 records reviewed, 379 patients (75%) were prescribed BZDs or Z-drugs; only 182 (48%) of them had clearly documented indications for their use. Three hundred and seven patients (60%) were diagnosed with insomnia; none of them received CBT-I as initial treatment. No patients on long-term use of hypnotics were reviewed by their physicians after they began using the medication. More than 43% of patients were prescribed anti-histamines for insomnia. No records met all (or even six) of the seven criteria. KFCH physicians do not follow US guidelines. Therefore, the Ministry of Health (MOH) should improve its administrative systems including documentation, and instead of using international guidelines that are seldom followed, physicians should be trained in prescribing hypnotics and national guidelines need to be developed.
Collapse
|
15
|
Sleep deprivation: prevalence and associated factors among adolescents in Saudi Arabia. Sleep Med 2019; 53:165-171. [DOI: 10.1016/j.sleep.2018.08.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022]
|
16
|
Omair MA, Alobud S, Al-Bogami MH, Dabbagh R, Altaymani YK, Alsultan N, Alhazzani A, Omair MA. Prevalence of fibromyalgia in physicians in training: a cross-sectional study. Clin Rheumatol 2018; 38:165-172. [PMID: 30284078 DOI: 10.1007/s10067-018-4313-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/19/2018] [Accepted: 09/23/2018] [Indexed: 12/20/2022]
Abstract
The prevalence of fibromyalgia (FM) in physicians in training (PIT) in Saudi Arabia is unknown. The aim of this study is to evaluate the prevalence of FM in PIT using different screening tools and factors associated with its development. We also aimed at evaluating the level of agreement and correlation between screening tools. This was a cross-sectional study conducted in a single academic institution. PIT were invited to fill three questionnaires: Fibromyalgia Rapid Screening tool (FirST), Fibromyalgia Survey Questionnaire (FSQ), and London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). A total of 182 PIT completed the questionnaire. They were predominantly males (57.1%), single (56.0%), and at resident level (86.7%). The median age was 28 (interquartile range = 4). The average number of house-calls/month was 3.2 (SD = 2.3). The prevalence of FM using the FirST, FSQ, and LFESSQ was 6.0%, 8.2%, and 11.6%, respectively. Six (3.3%) fulfilled the three criteria concurrently. After adjusting for different variables using the FSQ, PIT with family history of FM had 23.6 times the odds for testing positive (95% CI = 3.12, 178.37), and every extra house-call/month was associated with a 50% increase in the odds for testing positive for FM (95% CI = 1.00, 2.25). Percent agreement between tools was high (all > 86%). Results for kappa coefficient showed moderate agreement between FSQ scores and each of FirST and LFESSQ. There was poor agreement between FirST and LFESSQ. FM is prevalent among PIT. There is a high percent agreement and poor to moderate correlation between the screening tools used.
Collapse
Affiliation(s)
- Mohammed A Omair
- Division of Rheumatology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia. .,Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Sarah Alobud
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Rufaidah Dabbagh
- Community Medicine Unit, Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Nour Alsultan
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abeer Alhazzani
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Maha A Omair
- Department of Statistics and Operations Research, College of Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
17
|
Abdullah B, Idris AI, Mohammad ZW, Mohamad H. Validation of Bahasa Malaysia STOP-BANG questionnaire for identification of obstructive sleep apnea. Sleep Breath 2018; 22:1235-1239. [PMID: 29682698 DOI: 10.1007/s11325-018-1663-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/16/2018] [Accepted: 04/11/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The diagnosis of obstructive sleep apnea (OSA) by polysomnography (PSG) is time-consuming and expensive. The STOP-BANG questionnaire (SBQ) is an adequate screening tool and easily applied. We aimed to validate the Bahasa Malaysia version for use in sleep clinic. METHODS A cross-sectional study was carried out in the sleep clinic. Standard forward-backward method was used for translation. Patients were required to answer a translated version of the questionnaire in Bahasa Malaysia and underwent a PSG study. Apnea-hypopnea index (AHI) of five and more was considered diagnostic. SBQ score was divided into two groups, less than 3 and 3 or more to determine its correlation with mild, moderate, or severe OSA. The reliability of the questionnaire was compared against that of the PSG result. RESULTS We recruited 134 patients with mean age of 41.22 ± 12.66 years old. 9.7% patients have low risk, 48.5% moderate risk, and 41.8% high risk of OSA by SBQ scoring. 28.4% of patients had mild, 33.6% had moderate, and 38.0% had severe OSA by PSG. The Bahasa Malaysia version had sensitivity, specificity, and positive and negative predictive value of 61.42, 71.05, and 84.06 and 41.54% respectively. When the score is higher, the probability increases for patients to have moderate or severe OSA. SBQ score showed moderate value of agreement to AHI. CONCLUSIONS The Bahasa Malaysia version of SBQ is a valid tool for the identification of OSA. It is useful to detect patients at risk for further investigation and management.
Collapse
Affiliation(s)
- Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Anuar Idwan Idris
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Hazama Mohamad
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
18
|
Saleem AH, Al Rashed FA, Alkharboush GA, Almazyed OM, Olaish AH, Almeneessier AS, BaHammam AS. Primary care physicians' knowledge of sleep medicine and barriers to transfer of patients with sleep disorders. A cross-sectional study. Saudi Med J 2018; 38:553-559. [PMID: 28439609 PMCID: PMC5447220 DOI: 10.15537/smj.2017.5.17936] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess primary care physicians' (PCPs) knowledge and attitudes toward sleep disorders. Methods: In this cross-sectional quantitative study, we surveyed 88 primary care centers under the Ministry of Health during 2015 in Riyadh, Saudi Arabia, using a combination of pre-designed validated questionnaires. Knowledge was assessed using the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire, and attitude was assessed using a pre-designed survey. For numerical variables, t-test was used, and for categorical variables, Chi-square test was used. Results: Data from 223 PCPs (males 50.2%) were analyzed. Among the participants, 44 (19.9%) did not know that sleep medicine is a distinct medical specialty, and 24 (10.9%) felt that sleep disorders are uncommon medical problems based on their daily practice. Only 87 (39%) of physicians stated that they referred patients with sleep disorders to specialized medical centers for further management. The mean score of the ASKME questionnaire was 14.4 ± 4 out of 30 (48%). The majority of physicians (78.5%) obtained a score between 11 and 20. Score results were not related to gender or years of practice. Conclusion: Primary care physicians' have a low level of awareness and poor knowledge of sleep medicine and sleep disorders.
Collapse
Affiliation(s)
- Ahmed H Saleem
- Department of Medicine, Sleep Disorders Center, College of Medicine, King Saud University, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | | | | | |
Collapse
|
19
|
Al Shareef SM, Almeneessier AS, Hammad O, Smith RM, BaHammam AS. The sleep architecture of Saudi Arabian patients with Kleine-Levin syndrome. Saudi Med J 2018; 39:38-44. [PMID: 29332107 PMCID: PMC5885119 DOI: 10.15537/smj.2018.1.21045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To establish baseline sleep architecture during an acute attack of Kleine-Levin syndrome (KLS) in a cohort of Saudi Arabian KLS patients and compare these characteristics with other published cohorts. Methods: This was a retrospective cohort study of the polysomnographic characteristics of 10 typical symptomatic Saudi Arabian KLS patients attending the University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia between 2002 and 2015. Data were captured by nocturnal polysomnography during an acute attack of hypersomnia and compared with other published cohorts identified via a systematic literature search. Results: Self-reported time asleep during episodes (11.1±6.7 hours) and recorded total sleep time (TST) (322.5±108.7 minutes) were generally shorter than other published cohorts. Sleep efficiency was poor at 75.0%±25.1%, with low relative amounts of rapid eye movement (REM) sleep (16.5±5.9% of TST) and deep non-REM sleep (stage N3; 10.5±6.0% of TST) and high relative amounts of non-REM sleep (stage N1; 7.0±4.3% of TST). The sleep architecture of Saudi Arabian KLS patients was similar to other published cohorts. Conclusions: Sleep architecture of our cohort was relatively normal and broadly similar to other published studies, the main features being low sleep efficiency and low relative amounts of REM and stage N3 sleep. Time-course polysomnography studies with functional imaging may be useful to further establish the exact pathophysiology of this disease.
Collapse
Affiliation(s)
- Saad M Al Shareef
- Department of Internal Medicine, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | |
Collapse
|
20
|
Al-Tannir M, Kobrosly SY, Al-Badr AH, Salloum NA, Altannir YM. Characterizing sleeping habits and disturbances among Saudi adults. Saudi Med J 2017; 37:1372-1380. [PMID: 27874154 PMCID: PMC5303777 DOI: 10.15537/smj.2016.12.17373] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives To characterize sleeping habits, assess sleep disturbance prevalence, and identify associated factors among Saudi adults. Methods A total of 1720 adults were approached for this observational cross-sectional study between October 2014 and March 2015. The study took place in Riyadh, the capital of Saudi Arabia. We used a questionnaire to describe sleeping characteristics in relation to existing chronic diseases, smoking status, obesity, daily performance and sociodemographic variables. Results The response rate was 79.6% (1369 participants), 61.6% have or may have sleeping disturbances of which 18.6% claimed either slowed or stopped breathing during sleep. Women reported a higher prevalence of sleep disturbances (65.2%). Feeling tired was significantly associated with sleep disturbance (49% versus 19.7%) (p<0.001). Approximately 78.4% of those with sleep disturbance significantly believed that their ability to perform daily tasks is affected (p=0.005). Moreover, smoking and obesity were significantly associated with sleep disturbances (p<0.01). Participants with asthma, hypertension, chronic heart disease, and diabetes mellitus reported significantly more sleeping disturbance (p=0.016 to p=0.001). Conclusions Sleep disturbances are associated with obesity, smoking, chronic health conditions, and lower performance among Saudi adults.
Collapse
Affiliation(s)
- Mohamad Al-Tannir
- Clinical and Translational Research Department, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | |
Collapse
|
21
|
Almeneessier AS, BaHammam AS. Sleep Medicine in Saudi Arabia. J Clin Sleep Med 2017; 13:641-645. [PMID: 28212693 PMCID: PMC5359344 DOI: 10.5664/jcsm.6566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 11/13/2022]
Abstract
ABSTRACT The practice of sleep medicine in Saudi Arabia began in the mid to late 1990s. Since its establishment, this specialty has grown, and the number of specialists has increased. Based on the available data, sleep disorders are prevalent among the Saudi population, and the demand for sleep medicine services is expected to increase significantly. Currently, two training programs are providing structured training and certification in sleep medicine in this country. Recently, clear guidelines for accrediting sleep medicine specialists and technologists were approved. Nevertheless, numerous obstacles hamper the progress of this specialty, including the lack of trained technicians, specialists, and funding. Increasing the awareness of sleep disorders and their serious consequences among health care workers, health care authorities, and insurance companies is another challenge. Future plans should address the medical educational system at all levels to demonstrate the importance of early detection and the treatment of sleep disorders. This review discusses the current position of and barriers to sleep medicine practice and education in Saudi Arabia.
Collapse
Affiliation(s)
| | - Ahmed S. BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
22
|
BaHammam AS, ALAnbay E, Alrajhi N, Olaish AH. The success rate of split-night polysomnography and its impact on continuous positive airway pressure compliance. Ann Thorac Med 2015; 10:274-8. [PMID: 26664566 PMCID: PMC4652294 DOI: 10.4103/1817-1737.160359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES: With the increased volume of referrals of patients with obstructive sleep apnea (OSA) for sleep studies, there is a great need for alternatives of the standard two-night polysomnography (PSG) like split-night PSG. Therefore, we conducted this study to determine the success rate of continuous positive airway pressure (CPAP) titration during split-night PSG, and to determine the predictors of titration success and the impact on subsequent CPAP compliance in Saudi patients with OSA. METHODS: This is a prospective cohort study that included consecutive patients who were diagnosed with OSA and underwent a split-night PSG (n = 454). A subgroup of patients who used CPAP therapy, agreed to come for follow-up after 4 and 10 months (n = 130). This subgroup was compared with a matched group of OSA patients who underwent a two-night sleep study protocol (n = 80). RESULTS: The study group had a mean age of 48.7 ± 13.3 years, body mass index (BMI) of 37.5 ± 10.1 kg/m2 and apnea hypopnea index of 58.4 ± 35.0 events/h. Successful CPAP titration was achieved in 350 (77%) patients. In a full adjusted model, “BMI >35 kg/m2” and “known cardiac disease” remained significant predictors of a lower success rate of CPAP titration. After 10 months, 88% of the patients in the split-night protocol met the set criteria for good compliance versus 85% in the two-night protocol. CONCLUSION: Split-night protocol is an effective protocol for diagnosing OSA and titrating CPAP. CPAP compliance rate showed no difference between the split-night and the two-night protocols.
Collapse
Affiliation(s)
- Ahmed S BaHammam
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia
| | - Eiman ALAnbay
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia
| | - Nuha Alrajhi
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia
| | - Awad H Olaish
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia
| |
Collapse
|
23
|
Developing Sleep Medicine Internationally. Ann Am Thorac Soc 2015; 12:1267-8. [DOI: 10.1513/annalsats.201507-452ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
BaHammam AS, Al-Aqeel AM, Alhedyani AA, Al-Obaid GI, Al-Owais MM, Olaish AH. The Validity and Reliability of an Arabic Version of the STOP-Bang Questionnaire for Identifying Obstructive Sleep Apnea. Open Respir Med J 2015; 9:22-9. [PMID: 25834656 PMCID: PMC4378065 DOI: 10.2174/1874306401509010022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/24/2015] [Accepted: 02/24/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common, serious, under-recognized and under-diagnosed medical disorder. Polysomnography (PSG) is the gold standard diagnostic test for OSA; however, the cost of testing and the shortage of sleep disorders laboratories limit access to this tool. Therefore, there is a need for a simple and reliable diagnostic tool to screen patients at risk of OSA. OBJECTIVE This study was conducted to evaluate the validity and reliability of an Arabic version of the STOP-Bang questionnaire (SBQ) as a screening tool for OSA. METHODS This study was conducted in three steps, as follows: Step 1: the SBQ was translated from English to Arabic (examining both forward and backward translations); Step 2: the test-retest reliability of the questionnaire was investigated; and Step 3: the questionnaire was validated against PSG data prospectively on 100 patients attending a sleep disorders clinic who were subjected to a full-night PSG study after completing the translated version of the SBQ. The validity of the test was tested against the apnea-hypopnea index (AHI). RESULTS The study group had a mean age of 46.6 ± 14.0 years and a mean AHI of 50.0 ± 37.0/hour. The study demonstrated a high degree of internal consistency and stability over time for the translated SBQ. The Cronbach's alpha coefficient for the 8-item tool was 0.7. Validation of the SBQ against the AHI at a cut-off of 5 revealed a sensitivity of 98% and positive and negative predictive values of 86% and 67%, respectively. CONCLUSION The Arabic version of the SBQ is an easy-to-administer, simple, reliable and valid tool for the identification of OSA in the sleep disorders clinic setting.
Collapse
Affiliation(s)
- Ahmed S. BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, and National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
25
|
Merdad RA, Merdad LA, Nassif RA, El-Derwi D, Wali SO. Sleep habits in adolescents of Saudi Arabia; distinct patterns and extreme sleep schedules. Sleep Med 2014; 15:1370-8. [DOI: 10.1016/j.sleep.2014.06.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/24/2014] [Accepted: 06/09/2014] [Indexed: 10/24/2022]
|
26
|
Scientific research in obstructive sleep apnea syndrome: bibliometric analysis in SCOPUS, 1991–2012. Sleep Breath 2014; 19:109-14. [DOI: 10.1007/s11325-014-0969-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 02/20/2014] [Accepted: 02/26/2014] [Indexed: 01/16/2023]
|
27
|
Bahammam AS, Alsaeed M, Alahmari M, Albalawi I, Sharif MM. Sleep medicine services in Saudi Arabia: The 2013 national survey. Ann Thorac Med 2014; 9:45-7. [PMID: 24551019 PMCID: PMC3912688 DOI: 10.4103/1817-1737.124444] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 08/03/2013] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND: We conducted this national survey to quantitatively assess sleep medicine services in the Kingdom of Saudi Arabia (KSA) and to identify obstacles that specialists and hospitals face, precluding the establishment of this service. MATERIALS AND METHODS: A self-administered questionnaire was designed to collect the following: General information regarding each hospital, information regarding sleep medicine facilities (SFs), the number of beds, the number of sleep studies performed and obstacles to the establishment of SFs. The questionnaire and a cover letter explaining the study objectives were mailed and distributed by respiratory care practitioners to 32 governmental hospitals and 18 private hospitals and medical centers in the KSA. RESULTS: The survey identified 18 SFs in the KSA. The estimated per capita number of beds/year/100,000 people was 0.11 and the per capita polysomnography (PSG) rate was 18.0 PSG/year/100,000 people. The most important obstacles to the progress of sleep medicine in the KSA were a lack of trained sleep technologists and a lack of sleep medicine specialists. CONCLUSION: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.
Collapse
Affiliation(s)
- Ahmed S Bahammam
- University Sleep Disorders Center, Department of Medicine, College of Medicine, and National Plan for Science and Technology, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mashni Alsaeed
- Sleep Disorders Center, Department of Medicine, King Faisal Specialist Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Alahmari
- Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Ibrahim Albalawi
- Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Munir M Sharif
- University Sleep Disorders Center, Department of Medicine, College of Medicine, and National Plan for Science and Technology, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
28
|
Almohaya A, Qrmli A, Almagal N, Alamri K, Bahammam S, Al-Enizi M, Alanazi A, Almeneessier AS, Sharif MM, BaHammam AS. Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools. BMC MEDICAL EDUCATION 2013; 13:133. [PMID: 24070217 PMCID: PMC3849688 DOI: 10.1186/1472-6920-13-133] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/24/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education. METHODS We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored <60%. To assess the number of teaching hours dedicated to sleep medicine in the undergraduate curricula, the organizers of the major courses on sleep disorders were contacted to obtain the curricula for those courses and to determine the obstacles to education. RESULTS A total of 348 students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%). CONCLUSIONS Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools must provide adequate sleep medicine education.
Collapse
Affiliation(s)
- Abdulellah Almohaya
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | - Abdulaziz Qrmli
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | - Naeif Almagal
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | - Khaled Alamri
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | - Salman Bahammam
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mashhour Al-Enizi
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | - Atif Alanazi
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
| | | | - Munir M Sharif
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
- National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed S BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia
- National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
29
|
Bahammam AS, Al-Jahdali H, Alharbi AS, Alotaibi G, Asiri SM, Alsayegh A. Saudi regulations for the accreditation of sleep medicine physicians and technologists. Ann Thorac Med 2013; 8:3-7. [PMID: 23440260 PMCID: PMC3573555 DOI: 10.4103/1817-1737.105710] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 10/10/2012] [Indexed: 11/27/2022] Open
Abstract
The professional content of sleep medicine has grown significantly over the past few decades, warranting the recognition of sleep medicine as an independent specialty. Because the practice of sleep medicine has expanded in Saudi Arabia over the past few years, a national regulation system to license and ascertain the competence of sleep medicine physicians and technologists has become essential. Recently, the Saudi Commission for Health Specialties formed the National Committee for the Accreditation of Sleep Medicine Practice and developed national accreditation criteria. This paper presents the newly approved Saudi accreditation criteria for sleep medicine physicians and technologists.
Collapse
Affiliation(s)
- Ahmed S Bahammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
30
|
Affiliation(s)
- Ahmed S Bahammam
- Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
31
|
Al-Hazzaa HM, Musaiger AO, Abahussain NA, Al-Sobayel HI, Qahwaji DM. Prevalence of short sleep duration and its association with obesity among adolescents 15- to 19-year olds: A cross-sectional study from three major cities in Saudi Arabia. Ann Thorac Med 2012; 7:133-9. [PMID: 22924070 PMCID: PMC3425044 DOI: 10.4103/1817-1737.98845] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Accepted: 02/25/2012] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Adequate sleep has been considered important for the adolescent's health and well being. On the other hand, self-imposed sleep curtailment is now recognized as a potentially important and novel risk factor for obesity. The present study aimed to assess the prevalence of short sleep duration and its association with obesity among Saudi adolescents. METHODS This is a school-based cross-sectional study with self-reported sleep questionnaires. It was conducted during the years 2009/2010 in three cities in Saudi Arabia; Al-Khobar, Jeddah, and Riyadh. Participants were 2868 secondary-school males (1379) and females (1389) aged 15 to 19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, waist circumference, BMI, and sleeping duration. Logistic regression analysis while adjusted for age, gender, and location was used to examine the associations between sleep duration and obesity measures. RESULTS The mean (SD) of sleep duration was 7.2 (1.6) hours/day with no significant differences between males and females. About 31% of the participants obtain less than 7 hours of sleep per day, while approximately 50% of the sample gets less than 8 hours of daily sleep. Two-way ANCOVA results while controlling for the effect of age revealed a significant gender by school-type interaction (P<0.001). In addition, adequate sleep duration increased the odds of having normal weight (adjusted odds ratios = 1.28, 95% CI = 1.08-1.50, P = 0.003). CONCLUSION The present study observed a high prevalence of short sleep duration among Saudi adolescents 15- to 19-year olds and that short sleep duration was significantly associated with increased risk of overweight and obesity. Future interventions should investigate whether adopting a healthy lifestyle by adolescents with short sleep duration would improve their sleeping habits or not.
Collapse
Affiliation(s)
- Hazzaa M Al-Hazzaa
- Pediatric Exercise Physiology Laboratory, College of Education, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|