Why so many people in the Middle East are suffering from sleep deprivation and disorders

In Saudi Arabia, sleep issues seem to be significantly worse than in many other countries. (Shutterstock)
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Updated 17 March 2023

Why so many people in the Middle East are suffering from sleep deprivation and disorders

  • On World Sleep Day, doctors in Saudi Arabia and the UAE explain why getting enough quality rest is essential for health
  • Anxiety, excessive screen time, and the consequences of the COVID-19 pandemic have all impacted sleep quality

DUBAI: The average person spends almost one-third of their life asleep — a necessary biological function that allows our bodies to rest and recover, support mental wellbeing, restock our immune system, and regulate our metabolism.

However, one of the most common complaints among people of all backgrounds is a persistent feeling of tiredness and a sense we are not getting enough quality sleep, leaving us unable to focus, regulate our emotions, fend off illness, or control our appetite.

For decades, studies on the topic of sleep have confirmed a growing prevalence of sleep disorders, threatening the health and quality of life of at least 45 percent of the world’s population.

On World Sleep Day, marked every year on March 17, experts emphasize the importance of getting at least seven to eight hours of sleep per night. This year, sleep health awareness activities are taking place under the theme “Sleep is essential for health.”

Anxiety, excessive screen time, and more recently the consequences of the coronavirus pandemic have all been cited as common causes of disturbed sleep and sleepless nights.

Dr. Rasha Mahmoud, head of the pulmonology and sleep unit at the Almana Group of Hospitals in Saudi Arabia, told Arab News: “Almost 40 percent of people in the Middle East are affected by sleep disorders, with obstructive sleep apnea syndrome being the most common disorder.”

A study on the global prevalence and burden of OSA, published in June by the US National Library of Medicine, showed that almost 1 billion people worldwide were affected by the sleep condition, with prevalence exceeding 50 percent in some countries.

OSA occurs when the throat muscles intermittently relax and block the airways during sleep, obstructing normal breathing for around 10 seconds before the sufferer jolts awake.

“Symptoms of this disorder include snoring, excessive daytime sleepiness, and morning headaches,” Mahmoud said.

In Saudi Arabia, sleep issues seem to be significantly worse than in many other countries.

According to a 2015 report from the mobile app Sleep Cycle, the Kingdom ranked second only to Japan in its list of the world’s five worst countries for average sleeping hours.

The Saudi Medical Journal confirmed that short sleep duration per night was prevalent in Saudi Arabia and affects one in every three Saudi adults.

“There are multiple factors that impact the quality and duration of sleep, starting with anxiety along with sedentary lifestyle diseases,” Mahmoud added.

Specific jobs that require long or unfixed working hours and night shifts are another factor impacting the quality of sleep among Saudis.

Mahmoud said: “High screen time, be it on social media or even gaming, can also affect the quality of sleep leading to various sleep disorders.”

The Kingdom ranks third globally for smartphone usage, at 24.2 million users, with almost 75 percent of the population using smartphones and more than 95 percent the internet.

Dr. Vishwanath Gowraiah, head of the pediatric sleep medicine department at Danat Al-Emarat Hospital in Abu Dhabi, told Arab News: “Globally, we are seeing a rise in sleep disorders due to several lifestyle changes.

Dr. Rasha Mahmoud, head of the pulmonology and sleep unit at the Almana Group of Hospitals in Saudi Arabia.

“This has come to impact both the quality of sleep that individuals are receiving and quantity.”

He noted that sleeping disorders could affect young children from birth and persist into middle childhood and beyond.

Such disorders include OSA, parasomnias such as teeth grinding and sleepwalking, sleep terrors, confusional arousals known as ‘sleep drunkenness’ and nightmares, as well as delayed sleep-wake phase disorder, which is often seen in adolescents.

Meanwhile, adults generally suffer from sleep disorders such as obesity-related OSA, insomnia, narcolepsy, which makes people very drowsy during the day, shift work disorders and sleep-related movement disorders.

Gowraiah said: “Sleep helps the body undertake restorative measures to help us feel better, more alert, energetic, and awake.

“It helps us perform our day-to-day tasks and protects us from potential mental health triggers and allows the body to undergo vital maintenance to repair and regrow tissue, build bone and muscle, while also restoring the immune system.”

In fact, deep sleep has proven to support the release of growth hormones, to repair damage in the body, and to allow various systems to recover.

A lack of sleep, meanwhile, affects everything from memory, learning and performance to appetite and the ability to think clearly.

“If a person is chronically sleep-deprived, they may even experience neurological issues like mood swings and hallucinations,” Gowraiah added.


Regulating your sleep schedule: Try going to bed and waking up at the same time even on the weekends. This consistency will help your body develop a sleep-wake cycle.

Eating habits: Avoid heavy meals a few hours before your scheduled bedtime. Stimulants including nicotine, caffeine, and alcohol can also interfere with your sleep.

Create a peaceful setting: Calming yourself down before bed will help you deepen your sleep. Avoid the use of light-emitting screens just before bedtime. Include calming activities such as taking a bath or reading.

Physical activity during the day: Regular physical activity can promote better sleep. Stress management: Attempt to settle any of your worries or stresses before bedtime by getting organized or setting your daily priorities.

Source: Dr. Rasha Mahmoud, head of the pulmonology and sleep unit at the Almana Group of Hospitals in Saudi Arabia

Additionally, there is a higher risk of developing various health conditions or chronic health problems including obesity, diabetes, heart disease, high blood pressure, or sleep apnea.

“Some studies have shown that deprived rapid eye movement stage shortens lifespan and decreases immune function,” he said.

REM is one of several stages in the architecture of sleep. It happens about one hour after falling asleep and is when we tend to have our most vivid dreams. If the architecture of REM and non-REM sleep is disrupted, we can wake up feeling poorly rested.

As sleep problems are becoming more common among adults, experts are keen to develop better public understanding of the causes of disrupted sleep, and greater awareness of the available remedies can help reduce the burden of sleep disorders on society.

Dr. Vishwanath Gowraiah, head of the pediatric sleep medicine department at Danat Al-Emarat Hospital in Abu Dhabi.

A study published by the American Journal of Managed Care in 2007 estimated the annual costs of insomnia to be between $92.5 billion and $107.5 billion. This figure is likely to be far higher today.

Another study published by the Journal of Occupational and Environmental Medicine in 2010, based on staff questionnaires at four US corporations, said that fatigue-related productivity losses resulting from bad sleep were estimated to cost $1,967 per employee per year.

So why do so many people still underestimate the power of sleep and the impact it has on their well-being and quality of life?

Dr. Saliha Afridi, managing director of The LightHouse Arabia, a Dubai-based mental health and wellness clinic, told Arab News: “They think of sleep as rest, but they don’t realize that poor sleep impacts every part of your physical and mental health, even on a cellular level.”

Most people were operating “from a place of sleep debt,” she said, while also failing to understand that learning how to get a good night’s sleep was an important stress management and life skill.

“Sleep is done at night but is created in the day. Everything you do from the moment you wake up to the time it is time to lay in bed will impact how deeply you will rest that night.”

Afridi pointed out that a person’s risk of heart disease increased by 45 percent if they were sleep deprived, while those who slept six hours a night or less were five times more likely to suffer a heart attack than those who slept a full eight hours.

The same increased risk applies to conditions such as diabetes, high blood pressure, stroke, cancer, and hyperglycemia.

“Not all sleep is created equal. You require sufficient levels of deep sleep at night for your body to recover as well as for learning to consolidate,” Afridi added.

Healthy adults should get between seven and eight hours of sleep every night between the hours of 10 p.m. and 5 a.m., she said. “If they wake up in the middle of the night, they should be able to go back to sleep in 20 minutes or so.”

Dr Saliha Afridi.

Daytime naps are not recommended for those who are trying to regulate their sleep, she added.

Achieving the required hours of sleep was a particular challenge for many people during the pandemic. In fact, experts coined the term “COVID-somnia” in 2020 to describe difficulty falling asleep or staying asleep due to pandemic-related stressors or worries.

Afridi said: “The uncertainty and volatility that people experienced during the pandemic has continued since then and has impacted people’s mental health.”

She noted that nearly every mental health diagnosis had a sleep component to it, meaning a person’s psychology had a big impact on their sleep.

She also pointed to compromised physical health caused by long COVID or the after-effects of the virus, workplace stress due to hybrid working, and burnout for caregivers and essential workers who overextend themselves during the pandemic, all of which impacted the quality and quantity of sleep many were getting.

“We also see many people suffering with poor sleep due to mental health issues like anxiety and depression.

“Sleep is not just rest. It is the single most effective thing you can do for your brain and your body,” Afridi added.

UN rights investigator says EU aided and abetted abuse of migrants in Libya

Updated 27 March 2023

UN rights investigator says EU aided and abetted abuse of migrants in Libya

GENEVA: A member of the UN fact-finding mission to Libya investigating rights abuses said on Monday that European Union support for Libyan authorities that stop and detain migrants had “aided and abetted” the commission of rights violations against migrants.
“We’re not saying that the EU and its member states have committed these crimes. The point is that the support given has aided and abetted the commission of the crimes,” Chaloka Beyani said in a news conference while unveiling the mission’s report.

Iraq changes electoral law, sparking opposition anger

Updated 27 March 2023

Iraq changes electoral law, sparking opposition anger

  • The law revives the electoral law of 2018 and sweeps away one of the gains of the mass protest movement which shook Iraq

BAGHDAD: Iraq’s parliament voted Monday to restore electoral laws that were scrapped after 2019 anti-government demonstrations, sparking anger from independent lawmakers who see it benefiting larger parties.
The law, which parliament said in a statement was “adopted” without detailing the votes, revives the electoral law of 2018 and sweeps away one of the gains of the mass protest movement which shook Iraq.
After the protests, a new system favored the emergence of independent candidates, with some 70 independents winning seats in the 329-member parliament in the last legislative elections in 2021.
Parliament is dominated by the Coordination Framework, an alliance of powerful pro-Iran Shiite factions, from whose ranks Prime Minister Mohammed Shia Al-Sudani emerged.
The new law removes 83 electoral districts and creates 18 seats, one for each of Iraq’s provinces.
This “makes it easier for top party politicians to win seats,” analyst Sajad Jiyad said on Twitter.
Conversely, it will make it “harder for candidates in smaller parties and independents to compete” because they will be running at a provincial rather than a local level, he added.
During the debate, which ran from Sunday into the early hours of Monday, several angry independent lawmakers were expelled from the debating chamber, according to videos they filmed themselves.
The law also replaces a first past the post system with proportional representation.
Overall, the changes will benefit the larger parties and make it possible “for their candidates who didn’t get enough votes initially to win seats,” Jiyad added.
“Independent candidates will no longer have any hope of obtaining representation in parliament,” said Alaa Al-Rikabi, an independent lawmaker. “They will be crushed.”
But Coordination Framework lawmaker Bahaa Al-Dine Nouri welcomed the change, arguing that it will “distribute the seats according to the size of the parties.”
Nouri said this will “lead to the formation of a government within the time limits set by the constitution” to avoid the endless standoffs that followed the 2021 election.
The new law will apply to the next legislative elections, the date of which has not yet been set.
It will also apply to provincial elections slated for November 6, to be held in 15 of the 18 Iraqi provinces, excluding the three provinces in the autonomous Kurdistan region of northern Iraq.
In Iraqi Kurdistan, regional elections will take place on November 18 under a separate electoral system.

Saudi, Iranian foreign ministers to meet during Ramadan

Updated 27 March 2023

Saudi, Iranian foreign ministers to meet during Ramadan

  • The diplomats discussed in a phone call a number of issues relating to the trilateral agreement signed in China 
  • The Kingdom and Iran agreed on March 10 to re-establish diplomatic ties and reopen their embassies within two months

RIYADH: Saudi Arabia’s Foreign Minister Prince Faisal bin Farhan and his Iranian counterpart, Hossein Amir-Abdollahian, have agreed to meet during the month of Ramadan, the Saudi Press Agency reported early Monday. 

The diplomats also discussed in a phone call a number of issues relating to the trilateral agreement signed in China. 

"During the call, a number of common issues were discussed in light of the tripartite agreement that was signed in the People's Republic of China," Saudi state news agency SPA said. 

“The two ministers also agreed to hold a bilateral meeting between them during the ongoing month of Ramadan.” 

Ramadan is likely to end on April 20. 

The Kingdom and Iran agreed on March 10 to re-establish diplomatic relations and reopen their embassies within two months following years of tensions. 

Israeli Prime Minister Benjamin Netanyahu makes U-turn in judicial power grab

Israeli Prime Minister Benjamin Netanyahu attends a meeting at the Knesset, Israel’s parliament, in Jerusalem amid protests
Updated 28 March 2023

Israeli Prime Minister Benjamin Netanyahu makes U-turn in judicial power grab

  • With Israel in chaos amid mass protests, he said judicial reform plans will be delayed at least until parliament reconvenes on April 30
  • Opponents said protests will continue until the plans are scrapped; meanwhile Palestinians ponder short and long-term effects of the chaos on them

RAMALLAH: Benjamin Netanyahu on Monday delayed controversial judicial reforms that have plunged Israel into chaos and that critics say are a power grab. The prime minister halted the legislation until parliament reconvenes on April 30.

“When there’s an opportunity to avoid civil war through dialogue, I, as prime minister, am taking a timeout for dialogue,” he said. Netanyahu added that he remained determined to enact the judicial reforms but called for “an attempt to achieve broad consensus.”

After the announcement, the head of Israel’s largest trade union called off a general strike that had threatened to bring Israel’s economy to a standstill. Earlier, tens of thousands of Israelis demonstrated outside the Knesset in a dramatic escalation of the mass protest movement aimed at halting the reforms.

The chaos shut down much of the country. Departing flights from the main international airport were grounded. Shopping malls and universities closed their doors, diplomats at foreign missions stopped work, and hospital medical staff offered only emergency services.

The growing resistance to Netanyahu’s plans came hours after tens of thousands of people burst onto streets around the country in a spontaneous show of anger at the prime minister’s decision to fire his defense minister, who had called for a pause to the overhaul. Chanting “the country is on fire,” they lit bonfires on Tel Aviv’s main highway, closing the road and many others throughout the country for hours.

Demonstrators gathered again on Monday outside the Knesset, turning the streets surrounding the building and the Supreme Court into a roiling sea of blue-and-white Israeli flags. Large demonstrations in Tel Aviv, Haifa and other cities drew thousands more.

“This is the last chance to stop this move into a dictatorship,” said Matityahu Sperber, 68, who joined a stream of people headed to the protest outside the Knesset. “I’m here for the fight to the end.”

Netanyahu’s U-turn appeared to ease tensions somewhat but organizers of the grassroots anti-government protest movement said a delay would not be enough.

“A temporary freeze does not suffice, and the national protests will continue to intensify until the law is rejected in the Knesset,” organizers said.

Israel’s Arab citizens have largely ignored the protests. They said Israel’s democracy is already tarnished by its military rule over the occupied West Bank and the discrimination they face inside Israel itself.

One senior Palestinian leader told Arab News: “I see our task as Palestinians being to deepen the crisis inside Israel, which means that we do not support the opposition against Netanyahu, but rather weaken both sides because they will compete over who can harm the Palestinians the most.

“The issue of reforming the judiciary is not an internal matter. Rather, its goal is to control the West Bank. They want to reform the High Court because it was a brake on their racist occupation policies against the Palestinians.”

With Israel in turmoil, Palestinians are watching and wondering how the chaos might affect them in the short and long terms. Some say the crisis has reinforced the awareness that democracy and occupation cannot coexist. Others suggest that the Israeli security services are so preoccupied with the demonstrations in Tel Aviv and Jerusalem, it could to some degree loosen their iron grip on Palestinians in the West Bank and East Jerusalem.

There is also a belief among some that the protests will weaken Israel, ultimately to the benefit of the Palestinian people. Most believe, however, that any attacks by Palestinian resistance fighters inside Israel at this time would serve only to benefit Netanyahu and his right-wing coalition government partners, led by Bezalel Smotrich and Itamar Ben-Gvir, by distracting from their political predicament.

Taysir Khaled, a member of the Palestine Liberation Organization’s Executive Committee, said the situation in Israel offers a valuable opportunity for Palestinians to adopt a fresh political approach and work to deepen Israel’s isolation, in the region and internationally, by highlighting the fact that Israeli policies of occupation, discrimination, apartheid and ethnic cleansing are incompatible with the basic values of democracy.

Though Palestinians have had limited success when pleading their cases at Israel’s Supreme Court, failing to prevent Israeli authorities from annexing more Palestinian land, should Netanyahu and his government ultimately succeed in effectively seizing control of the court, Palestinians would have no refuge at all, other than the International Court of Justice in the Hague.

Palestinian political analyst Ghassan Al-Khatib told Arab News that if the wave of Israeli protests against the government continues, it will weaken the Israeli right wing, which would serve the interests of the Palestinian people.

In the meantime, however, one of the effects of the protests has been the closure of the Allenby Bridge, the only land crossing connecting the West Bank with Jordan, as the result of a strike by Israeli customs officials. This has paralyzed commercial traffic between Palestine and Jordan and the movement of travelers to and from the West Bank.

Amid fears that Netanyahu’s government might take action in the West Bank or Gaza Strip in an attempt to provoke a Palestinian response that would unite left and right wingers be creating a security threat, analysts and experts told Arab News that they do not believe the leaders of the Israeli security services would comply with any such attempt to launch deliberately provocative attacks at this time.

Retired Col. David Hacham, a former adviser on Arab affairs to the Israeli Ministry of Defense, said that Netanyahu cannot currently launch a military campaign against the West Bank in an attempt to divert attention from his plight. If Hamas was to attack Tel Aviv and security becomes a priority, however, the differences between politicians of the left and right might be set aside, he added.

Dana Ben Shimon, a correspondent for the newspaper Israel Today, agreed with Hacham and said: “(Hezbollah leader) Hassan Nasrallah and (Hamas leader) Yahya Sinwar are looking at the current chaos in Israel and whispering, saying, ‘We will not give Netanyahu and his government the gift of attacking Israel — let them be torn apart and drown on their own.’”

Shawan Jabarin, director of Al-Haq, a human rights organization in Ramallah, told Arab News: “The Palestinians must link the crisis in Israel to the existence of the occupation, as there is no difference between right and left when it comes to the Palestinians.”

Mohammed Darawsheh, strategic director of the Givat Habiba Center and a political analyst who lives in Israel, told Arab News that Arabs in the country have not participated in the protests against the judicial reforms because “we do not trust the Supreme Court and we are not part of the patriotism of Israel to demonstrate under its flag.”

Palestinians in Israel said that the Israeli Supreme Court is relatively liberal on Arab civil issues but is still part of the deep state in terms of legitimizing racism toward Arabs and the occupation.

Darawsheh said that should the judicial reforms eventually be implemented, Arabs in Israel will be much worse off. Arab schools that teach their students about the Nakba, for example, would lose 30 percent of their funding, he said. It is also possible that Arab political parties could be banned from the Israeli parliament, and budgets for services that benefit Arab citizens could be cut and the money redirected to settlers and Orthodox Jews.

Arab leaders should organize their own parallel protests against the planned reforms, Darawsheh said, to increase the pressure on Netanyahu and his government “because giving up our rights without fighting a battle is a huge mistake.”


Lebanon overturns unpopular decision to delay daylight saving time

Updated 28 March 2023

Lebanon overturns unpopular decision to delay daylight saving time

  • The unilateral decision taken by Prime Minister Najib Mikati to postpone daylight saving time for one month sparked controversy and sectarian reactions

BEIRUT: The Lebanese Cabinet decided to officially shift to daylight saving time overnight from Wednesday to Thursday, during an extraordinary session on Monday.

The unilateral decision taken by Prime Minister Najib Mikati late last week, following a discussion with Parliament Speaker Nabih Berri, to postpone daylight saving time for one month sparked controversy and sectarian reactions, especially by the Maronite community.

Mikati’s decision showed how easily Lebanon could slip into more division, a reflection of the political tension stemming from the five-month presidential vacuum.

“Since former President Michel Aoun’s term ended, I have been tirelessly working with a group of ministers, the army, security forces, and…public administration employees to preserve the structure of the Lebanese state, which, if it collapses, becomes very difficult to reconfigure. I have never been a fan of defiance or encroaching on religious authorities,” Mikati said Monday.

“The decision was aimed at (allowing) those fasting during the month of Ramadan (to rest) for an hour without causing any harm to any other Lebanese component,” he said.

“I never imagined that some would consider this a confessional or sectarian decision…I have been struggling under a mountain of accusations and deceptions.

“I steadfastly endured and suffered in silence, but today I place everyone before their responsibilities.

“The easiest thing for me to do is to refrain from holding Cabinet sessions, and the most difficult thing is to continue to bear the responsibility. Every person has a personal endurance level, and mine is running low.

“The main problem is the vacancy in the presidency, and I do not take responsibility for this vacuum. Those responsible are the political and spiritual leaders, primarily those parliamentary blocs that disrupted the quorum during 11 election sessions, and those that pledged not to secure it in subsequent sessions without agreeing on a candidate.”

Mikati stressed that the Sunni community he represents “has always been patriotic…and preserved throughout history the unity of the country and its institutions and (has) worked, through its elites and leaders, to formulate national, non-sectarian projects since Lebanon’s independence.”

He added the announcement to overturn last week’s decision requires “a 48-hour delay to settle some technical matters,” in reference to rescheduling flight times to and from Beirut and scheduling computer servers in institutions and mobile phone networks.

The Lebanese have been divided over the decision. Some private media institutions and educational institutions have refused to abide by Mikati’s decision. Caretaker Minister of Education Abbas Halabi said in a statement Sunday that “daylight saving time remains approved and applied in the educational sector.”

Those who rejected Mikati’s decision argued that amending the daylight saving time requires a Cabinet decision and that Mikati took it unilaterally, which is why the Cabinet convened Monday to discuss the issue exclusively.

The Lebanese Cabinet will also hold a session to approve increases in public sector salaries and to implement an agreement to raise the minimum wage to 4,500,000 Lebanese pounds ($295), increase the transportation allowance to 125,000 Lebanese pounds, and double schooling and family allowances.