Sleep medicine services in Saudi Arabia: The 2013 national survey

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. 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. 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. 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

Prevalence of sleep-related accidents among drivers in Saudi Arabia

The prevalence of sleepy driving and sleep-related accidents [SRA] varies widely, and no data exist regarding the prevalence of sleepy driving in Saudi Arabia. Therefore, this study was designed to determine the prevalence and predictors of sleepy driving, near-misses, and SRA among drivers in Saudi Arabia. A questionnaire was developed to assess sleep and driving in detail based on previously published data regarding sleepy driving. The questionnaire included 50 questions addressing socio-demographics, the Epworth Sleepiness Scale [ESS], driving items, and the Berlin Questionnaire. In total, 1,219 male drivers in public places were interviewed face-to-face. The included drivers had a mean age of 32.4 +/- 11.7 years and displayed a mean ESS score of 7.2 +/- 3.8. Among these drivers, 33.1% reported at least one near-miss accident caused by sleepiness. Among those who had actual accidents, 11.6% were attributed to sleepiness. In the past six months, drivers reported the following: 25.2% reported falling asleep at least once during, driving and 20.8% had to stop driving at least once because of severe sleepiness. Young age, feeling very sleepy during driving, and having at least one near-miss accident caused by sleepiness in the past six months were the only predictors of accidents. Sleepy driving is prevalent among male drivers in Saudi Arabia. Near-miss accidents caused by sleepiness are an important risk factor for car accidents and should be considered as a strong warning signal of future accidents

Sleep estimation using BodyMedia's Sense Wear armband in patients with obstructive sleep apnea

We aimed to evaluate the validity of the BodyMedia's SenseWear Armband [BSA] device in estimating total sleep time [1[st]] in patients with obstructive sleep apnea [OSA]. Simultaneous overnight recordings of in-laboratory polysomnography [PSG] and BSA were performed on [1] 107 OSA patients [mean age of 45.2 +/- 14.3 years, mean apnea hypopnea index of 43 +/- 35.7/hr and [2] 30 controls matched with OSA patients for age and body mass index. An agreement analysis between the PSG and BSA scoring results was performed using the Bland and Altman method. There was no significant difference in OSA patients between BSA and PSG with regard to TST, total wake time, and sleep efficiency. There was also no significant difference in the controls between BSA and PSG with regard to TST, total wake time, and sleep efficiency. Bland Altman plots showed strong agreement between TST, wake time, and sleep efficiency for both OSA and the controls. The intraclass correlation coefficients revealed perfect agreement between BSA and PSG in different levels of OSA severity and both genders. The current data suggest that BSA is a reliable method for determining sleep in patients with OSA when compared against the gold standard test [PSG]. BSA can be a useful tool in determining sleep in patients with OSA and can be combined with portable sleep studies to determine TST

Sleep architecture of consolidated and split sleep due to the dawn [Fajr] prayer among Muslims and its impact on daytime sleepiness

Muslims are required to wake up early to pray [Fajr] at dawn [approximately one and one-half hours before sunrise]. Some Muslims wake up to pray Fajr and then sleep until it is time to work [split sleep], whereas others sleep continuously [consolidated sleep] until work time and pray Fajr upon awakening. To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 +/- 2.4 years. The participants spent three nights in the Sleep Disorders Center [SDC] at King Khalid University Hospital, where they participated in the study, which included [1] a medical checkup and an adaptation night, [2] a consolidated sleep night, and [3] a split-sleep night. Polysomnography [PSG] was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants. There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols. No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained

Prevalence of symptoms and risk of sleep apnea in middle-aged Saudi women in primary care

To assess the prevalence of symptoms and risks of obstructive sleep apnea [OSA] in a sample of middle-aged Saudi women in a primary care using a validated questionnaire. In this cross-sectional study, trained medical students administered the Berlin Questionnaire to a consecutive random sample of Saudi women in the age group 35-60 years, attending the primary health care center in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and July 2007. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSA. Four hundred women with a mean body mass index of 31.3+7.2 kg/m[2] were surveyed in this study. Among the study group, 40.8% reported snoring [everyday in 15%, 3-4 times a week in 7.5%, and one-2 times a week in 9.8%]. Breathing pauses more than 3 times per week was present in 22.5%. Hypertension was present in 24.8%. Based on the Berlin Questionnaire stratification for risk of OSA, 39% were considered as high-risk patients for OSA. In the primary care setting, the prevalence of symptoms of OSA among middle-aged Saudi women is very high. Almost 4 out of 10 middle-aged Saudi women are at risk for OSA, and may benefit from proper evaluation for OSA