Table 1 Characteristics of the included studies on the prevalence of sleep disorders among medical students in MENA.

From: Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis

Country

First author, year—reference

Study design

Sampling method

Data collection time

Population characteristics

Sleep disorder instrument

Prevalence description

Prevalence (%) of students with sleep disorder/issue

Insomnia disorders

 Insomnia

  Pakistan

Pervez120

CS

NR

January–April 2019

M: 80 (53.3%), F: 70 (46.7%), Mean age (SD): 23.14 (3.8)

AIS

Any disorder level/any academic period

36.6

M

31.5

F

42.8

  Pakistan

Zainab70

CS

Non-probability

September 2016–December 2017

Liaquat National Medical College, University years: 1–5, M: 111 (30.8%), F: 249 (69%), Mean age (SD): 21.98 (1.7)

ISI

Any disorder level/any academic period

17

  Pakistan

Khan121

CS

Non-probability

June–August 2018

University of Lahore, University years: 1–5, M: 106 (48.2%), F: 114 (51.8%)

ISI

Any disorder level/any academic period

51.8

F

75

  Pakistan

Khurshid122

Longitudinal

NR

2019

Local College of Lahore, Sample size: 309

Self-developed questionnaire

Any disorder level/any academic period

9.7

  Pakistan

Ali123

CS

Non-probability

March–April 2019

M: 350 (70%), F: 150 (30%)

NR

Any disorder level/any academic period

75.2

  Pakistan

Shakeel124

CS

Probability

February–May 2018

University years: 3–6, M: 75 (55.55%), F: 60 (44.44%), Mean age (SD): 21 (6.9)

AIS

Any disorder level/clinical training period

59.25

M

41.81

F

58.18

  Pakistan

Ram125

CS

Non-probability

NR

University years: 1–5, M: 35 (10.8%), F: 290 (89.2%), Mean age (SD): 20.55 (1.67)

AIS

Any disorder level/any academic period

33.5

M

40

F

32.8

  Saudi Arabia

Mohamed75

CS

Probability

NR

Medical students at Majmaah University, University years: 1–5, M: 145 (76.3%), F: 45 (23.7%)

NR

Any disorder level/any academic period

70

Mild

48.9

Moderate

17

Severe

17

  Saudi Arabia

Alfadeel126

CS

Non-probability

2015–2016

College of Medicine at Almaarefa colleges for science and technology (MCST), University years: 1–3, F: 150 (100%)

AIS

Pre-clinical

74

Clinical

72.8

Late clinical

76.6

  Saudi Arabia

Alrashed68

CS

Non-probability

During COVID-19

Medical students at King Saud University (KSU), University years: 3–5 M: 256 (55.3%), F: 207 (44.7%)

ISI

Any disorder level/any academic period

35

M

43

F

57

Year 3

36

Year 4

36.51

Year 4–5

28.92

Year 5

16.7

Intern

20.9

  Saudi Arabia

Mansour127

CS

Non-probability

October 2013–2014

College of Medicine, Taibah University, M: 38 (31.1), F: 84 (68.9), Mean age (SD): 20.5

Self-developed questionnaire

Any disorder level/any academic period

23.7

M

10.5

F

29.7

  Saudi Arabia

Alzahrani128

CS

Probability

Total duration including data collection took around 6 months for completion of the study

Majmaah University, M: 98 (75.4), F: 32 (24.6), University years: 2–5

Self-developed questionnaire

Any disorder level/any academic period

37.7

M

38.7

F

34.3

  Saudi Arabia

Goweda129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

31.5

  Saudi Arabia

Alshaaer73

NR

Non-probability sampling

NR

Alfaisal University College of Medicine University years: 2–3, Sample size: 129

AIS

Any disorder level/any academic period

62.1

  Jordan

Alqudah130

CS

Non-probability

NR

University years: 1- 6, M/F, Sample size: 299

ISI

Any disorder level/any academic period

70.2

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

18.3

M

17.8

F

18.8

  Jordan

Al-mistarehi72

NR

NR

NR

Jordan University of Science and Technology in Irbid, M: 410 (48.5%), F: 436 (51.5%), Mean age (SD): 22.4 (2.1)

SLEEP-50

Any disorder level/academic period NR

18.7

  Morocco

Essangri69

CS

Probability

April 8–18, 2020, During COVID

All medical universities in Morocco, University years: 1–8, M: 143 (26%), F: 406 (74%)

ISI

Mild

28.8

Moderate

26.8

Severe

7.1

M

50.3

F

67

Pre-clinical

67.6

Clinical

65.5

Late clinical

49.1

Sleep state misperception (paradoxical insomnia)

 Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

0.57

M

0.6

F

0.5

Sleep-related movement disorders

 Restless leg syndrome/periodic limb movement disorder

  Saudi Arabia

Goweda129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

22.4

  Saudi Arabia

Burhan76

CS

NR

February–May 2017

King Abdulaziz University, Sample size: 618, M/F

SLEEP-50

Any disorder level/academic period NR

39.29

  Pakistan

Ishaq131

CS

Non-probability sampling

June 2017–July 2018

Jinnah Medical and Dental Medical College (JMDC) DIMC), Liaquat College of Medicine and Dentistry (LCMD), and Al-Tibri Medical College (ATMC)), Karachi, M: 80 (26.6%), F: 220 (73.3%), Mean age: 21.3 (1.68)

RLS rating scale

Any disorder level/academic period NR

7

M

9

F

6

Mild

3

Moderate

4

  Jordan

Al-Mistarehi72

NR

NR

NR

Jordan University of Science and Technology in Irbid: M: 410 (48.5%), F: 436 (51.5%), Mean age (SD): 22.4 (2.1)

SLEEP-50

Any disorder level/academic period NR

14.2

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology or Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

10.3

M

7.3

F

13.1

  Egypt

Shalash132

CS

Non-probability

January–November 2013

Faculty of Medicine, Ain Shams University Cairo, M: 172 (44.2%), F: 217 (55.8%)

RLS rating scale

Moderate disorder level/any academic period NR

5.9

M

7.5

F

4.6

Sleep-related breathing disorders

 Obstructive sleep apnea

  Saudi Arabia

Goweda0129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

16.4

  Saudi Arabia

Burhan76

CS

NR

February–May 2017

King Abdulaziz, University, Sample size: 618

SLEEP-50

Any disorder level/academic period NR

26.81

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

12.1

M

15.4

F

9.1

  Jordan

Al-Mistarehi72

NR

NR

NR

Jordan University of Science and Technology in Irbid, M: 410 (48.5%), F: 436 (51.5%), Mean age (SD): 22.4 (2.1)

SLEEP-50

Any disorder level/academic period NR

12

  Pakistan

Zainab70

CS

Non-probability

September 2016–December 2017

Liaquat National Medical College, University years: 1–5, M: 111 (30.8%), F: 249 (69%), Mean age (SD): 21.98 (1.7)

BQ

Any disorder level/any academic period

20.6

Central disorders of hypersomnolence

 Hypersomnia

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

23

M

22.1

F

23.9

 Narcolepsy

  Saudi Arabia

Burhan, 201976

CS

NR

February–May 2017

King Abdulaziz University, Sample size: 618, M/F

SLEEP-50

Any disorder level/academic period NR

72.64

  Saudi Arabia

Goweda129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

51.6

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

7.8

M

8.7

F

7.1

Circadian rhythm sleep–wake disorders

 Circadian rhythm disorder

  Saudi Arabia

Goweda129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

22.4

  Jordan

Al-mistarehi72

NR

NR

NR

Jordan University of Science and Technology in Irbid, M: 410 (48.5%), F: 436 (51.5%), Mean age (SD): 22.4 (2.1)

SLEEP-50

Any disorder level/academic period NR

13.9

  Jordan

Yassin, 202071

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

13.2

M

14.8

F

11.9

Parasomnias

 Nightmares

  Saudi Arabia

Goweda129

CS

Probability sampling

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), University years: 2–6, M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

13.7

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

4.6

M

3

F

6

 Sleep walking

  Saudi Arabia

Goweda129

CS

Probability

During the ongoing global COVID-19 crisis and lockdown, February 10–1 April 2020

Umm Al-Qura University Faculty of Medicine, Bachelor of Medicine, University years: 2–6, Bachelor of Surgery (MBBS), M: 217 (49.5%), F: 221 (50.5%)

SLEEP-50

Any disorder level/any academic period

3.7

  Jordan

Yassin71

CS

Probability

Academic year 2018–2019

Jordan University of Science and Technology/Yarmouk University, M: 493 (47.4%), F: 548 (52.6%)

SLEEP-50

Any disorder level/any academic period

1

M

1.6

F

0.5

 Any sleep disorders

  Saudi Arabia

Almansour133

CS

Probability

NR

College of Medicine at King Saud University in Riyadh, University years: 1–5, M: 215 (50%), F: 215 (50%)

Self-developed questionnaire

Any disorder level/any academic period

9.5*

  1. *Calculated based on crude data.
  2. M male, F female, SD Standard deviation, CS cross-sectional study, RLS rating scale restless leg syndrome rating scale, REM rapid eye movement, NREM non-rapid eye movement, ISI insomnia severity index, AIS athens insomnia scale, BQ berlin questionnaire, NR not reported.
  3. Considered cut-offs for seep disorders RLS rating scale: Mild (1–10 points), Moderate (11–20 points); Severe (21–30 points); Very severe (31–40 points); Qualified individuals (meeting the International Restless Legs Syndrome Study Group (IRLSSG) criteria for the diagnosis of Restless Legs Syndrome (RLS)) to take this scale should have shown symptoms). ISI: Subthreshold insomnia (8–14 points); Clinical insomnia (moderate severity) (15–21 points); Clinical insomnia (severe) (22–28 points). AIS: Mild insomnia (6–9 points); Moderate insomnia (10–15), Severe insomnia (16–24). BQ: High risk for Obstructive Sleep Apnea (OSA) if two or more sections out of the three sections have positive scores.
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