Abbreviations
AHI Apnea–hypopnea index
BDI Beck depression inventory
BMI Body mass index
CBI Caregiver burden inventory
CBT Cognitive behavioral therapy
CD Compact disc
DTS Daytime sleeping
ESRD End-stage renal disease
FCs Family caregivers
GPA Grade point average
HD Hemodialysis
HrQoL Health-related quality of life
IBS Irritable bowel syndrome
ICU Intensive care unit
KSA Kingdom of Saudi Arabia
LA Left atrial
MCS Mental component summary
NICU Neonatal intensive care unit
OSAHS Obstructive sleep apnea–hypopnea syndrome
PCS Physical component summary
PHC Primary health center
PMR Progressive muscle relaxation
PSQ Poor sleep quality
PSQI Pittsburgh sleep quality index
RLS/PLMD Restless leg/period/periodic limb movement disorder
RTCs Road traffic collisions
T2DM Type-2 diabetes mellitus
TSD Total sleep duration
UAE United Arab Emirates
Introduction
The adequate sleeping had been documented to be essential for psychological well-being, cognitive processes, 1,2 and a wide number of adaptive cognitive and behaviors functions. 3–6 Sleep is a vital element for the general health of humans. The regular and sufficient sleep has been shown to be beneficial for human physiology in a number of various routes, from memory consolidation 7 to free radical removal, 8 and neurotoxic waste. 9
Prevalence of Sleep Disorders in Middle East Countries
Piro and Alhakem et al. 10 determined a broad range of sleep disorders in a random sample of medical students in a large university in Iraqi Kurdistan. They found that more than seventy percent (75.2%) of the students had no sufficient sleeping hours/24 h (<8 h/24 h). The prevalence of various sleep disorders was 13.6% (sleep apnea), 25.0 (insomnia), 14.6% (affective disorders), 1.3 (narcolepsy), 30.7% (restless leg/period/periodic limb movement disorder- RLS/PLMD), 19.6% (circadian rhythm), 5.7% (sleepwalking), 6.6% (nightmares), 0.6% (sleep state misconception), hypersomnia (0.0%), and 52.2% (all sleep disorders or at least one sleep disorder). The sleep disorders did not differ substantially between male and female students.
They found a high percentage of RLS/PLMD in the sample size (30.7%). This rate is so higher than its rate in the literature that is between 5% and 15% in the general population. 11 It is so higher than its prevalence in Saudi school employees which is 8.4% 12 and 5–15% in American and European populations. 13–15 The authors mentioned the possible reasons for the high rate of RLS/PLMD in this region: (a) geographic/demographic discrepancies, (b) different diagnostic criteria of RLS /PLMD, (c) secondary role of the sleep disorder, (d) founder effect of sleep disorders owing to ethnicity homogeneity, and (e) its correlation with insomnia and increased sleepiness. 16 In addition, (f) RLS development at younger ages (≤35 years) and family history in subjects with idiopathic type. 17
Vats and Mahboub et al. 18 reviewed the obesity and sleep-related breathing disorders in the Middle East. They recognized that the obesity and its consequent sleep-related breathing disorders are rising in the region, including United Arab Emirates (UAE), Kingdom of Saudi Arabia (KSA), Bahrain, Kuwait, Qatar, and Oman. The study published by the London School of Hygiene and Tropical Medicine reported that Kuwait has the second most obese men in the world. 19 A study conducted in a primary health center (PHC) setting in Dubai that estimated the prevalence of symptom and risk of obstructive sleep apnea–hypopnea syndrome (OSAHS) found that 20.9% of patients who attended the clinic were ...