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
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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.

TIPS FOR BETTER SLEEP

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.


El-Sisi, Al-Burhan discuss developments in Sudan

Updated 39 min 53 sec ago
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El-Sisi, Al-Burhan discuss developments in Sudan

  • Al-Burhan said that Egypt’s role in hosting Sudanese citizens and mitigating the crisis provided evidence of its continued friendship
  • El-Sisi and Al-Burhan agreed on the necessity of an immediate ceasefire in Gaza

CAIRO: Egypt’s President Abdel Fattah El-Sisi on Thursday received Gen. Abdel Fattah Al-Burhan, president of the Transitional Sovereignty Council of Sudan, at Cairo International Airport.

An official reception ceremony took place at Al-Ittihadiya Palace, at which the national anthems were played and guards of honor inspected.

The meeting focused on recent developments in Sudan and efforts to resolve its crisis.

The main goal is to restore stability while ensuring sovereignty, unity, and cohesion of the Sudanese state and its institutions.

The meeting was an attempt to meet the Sudanese people’s desire for safety and stability.

Ahmed Fahmy, the presidential spokesman, said that El-Sisi focused on the solid historic relations between the two countries, emphasizing Egypt’s support in enhancing cooperation.

The president stressed Egypt’s commitment to Sudan’s security and offered full support to achieve political, security, and economic stability.

He affirmed Egypt’s commitment to supporting Sudan’s unity and resolving ongoing conflicts.

He added that the two countries shared a close relationship, which made it necessary to ensure national security.

The president spoke of Egypt’s ongoing role in helping to alleviate the humanitarian impact of the current crisis within Sudan.

Al-Burhan expressed his country’s appreciation for Egypt’s support. He highlighted the long-standing ties between the two countries, while saying that Egypt’s role in hosting Sudanese citizens and mitigating the crisis provided evidence of its continued friendship.

The parties also discussed the situation in Gaza and regional issues of mutual concern.

El-Sisi and Al-Burhan agreed on the necessity of an immediate ceasefire and the urgent need to ensure the delivery of humanitarian aid to Gaza.

They also agreed to continue consultations and coordination to help benefit the populations of Egypt and Sudan.

The Sudanese leader made an official visit to Egypt in August last year, his first following the start of his country’s conflict in April. Al-Burhan and El-Sisi met in the city of Alamein in northern Egypt.


Palestinian president issues ‘categorical rejection’ of Israeli PM’s post-war plan

Updated 29 February 2024
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Palestinian president issues ‘categorical rejection’ of Israeli PM’s post-war plan

  • Netanyahu wants Israel to retain security control over Palestinian areas and make reconstruction dependent on demilitarization
  • Abbas charged that the plan confirmed the Israeli government’s intentions to recolonize the Gaza Strip

CAIRO: Palestinian President Mahmoud Abbas has stressed “categorical Palestinian rejection” of the principles announced in Israeli Prime Minister Benjamin Netanyahu’s so-called post-war plan for Gaza.

Netanyahu wants Israel to retain security control over Palestinian areas and make reconstruction dependent on demilitarization.

His plan, which brings together a range of well-established Israeli positions, underlines Netanyahu’s resistance to the creation of a Palestinian state which he sees as a security threat.

Arab League Secretary-General Ahmed Aboul Gheit has received a written message from Abbas which calls for a global conference to adopt a comprehensive peace plan with international guarantees and a timeline for implementation of the ending of the Israeli occupation of Palestinian territories.

Abbas has called on the league to support Palestine in obtaining full membership of the UN.

The message urged countries that have not yet recognized Palestine to do so.

Aboul Gheit received Ambassador Muhannad Al-Aklouk, representative of Palestine to the bloc, at the headquarters of the general secretariat, and Al-Aklouk had brought a message from Abbas.

Jamal Rushdi, a spokesperson for the Arab League chief, said that the president’s message included a categorical Palestinian rejection of the principles announced by the Israeli prime minister for the so-called “day after of the war.”

The message included a warning of the danger of those principles — especially the denial of the existence of the Palestinian people, and insisting on imposing Israeli sovereignty on the land extending from the Mediterranean Sea to the Jordan River.

Abbas charged that the plan confirmed the Israeli government’s intentions to recolonize the Gaza Strip and perpetuate the occupation in the West Bank and East Jerusalem through plans to build thousands of settlement units.

Rushdi said that the message warned that the goal of the Israeli government was not only to undermine the chances of peace based on the two-state solution, but also to intensify ethnic cleansing and displacement of Palestinians from the Gaza Strip, the West Bank, and East Jerusalem.

The president’s message included the affirmation that the Gaza Strip is an integral part of the State of Palestine.

The Palestinian Authority is ready to assume the responsibilities of governance in the Gaza Strip, the West Bank, and East Jerusalem, and is prepared to work toward establishing security and peace, as well as stability, in the region within the framework of a comprehensive peace plan.

The message called on the Arab League’s chief to continue working for a ceasefire; the provision of humanitarian aid; the return of displaced people to their homes in the north; the prevention of their displacement; and a halt to Israel’s expansionist plans and practices in the Gaza Strip.

Aboul Gheit confirmed to Al-Aklouk that he would continue to work to achieve all the goals highlighted in the president’s message — most notably an immediate ceasefire, working to bring aid in urgently and sustainably, and standing with full force against the displacement plan.

Aboul Gheit stressed that stopping the war remained a fundamental priority for the Arab League and its member states.

He reiterated that the Palestinians, Arabs, and the world always rejected the displacement plan.

Aboul Gheit pointed out that addressing the humanitarian catastrophe caused by Israeli aggression could not be achieved in isolation from a settlement aiming at the emergence of a Palestinian state in the West Bank and Gaza.

He emphasized that the Palestinians were capable of governing themselves.

Aboul Gheit added that the continuation of the occupation was no longer possible and that the two-state solution remained the only formula capable of achieving security, peace, and stability between Palestinians and Israelis in the region and the world.


Israel says it’s still reviewing access to Al Aqsa mosque during Ramadan

Updated 29 February 2024
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Israel says it’s still reviewing access to Al Aqsa mosque during Ramadan

  • Al Aqsa, Israel’s third-holiest shrine, is a focus of Palestinian statehood hopes
  • Israeli controls on access have often stoked political friction, especially during Ramadan

JERUSALEM: Israel is reviewing possible curbs on access to Al Aqsa mosque in Jerusalem over the upcoming Ramadan fasting month, a government spokesperson said after media reports that the far-right minister for police might be overruled on the issue.
Al Aqsa, Israel’s third-holiest shrine, is a focus of Palestinian statehood hopes. The site is also revered by Jews as vestige of their two ancient temples. Israeli controls on access have often stoked political friction, especially during Ramadan.
National Security Minister Itamar Ben-Gvir said last week there would be a quota for members of Israel’s 18 percent Muslim minority who wish to take part in peace prayers at Al Aqsa.
That would compound the clampdown Israel has already placed on Palestinians since the Hamas’ cross-border rampage from the Gaza Strip on Oct. 7, codenamed “Al Aqsa Flood,” which triggered the ongoing Gaza war.
But Israel’s top-rated Channel 12 TV reported on Wednesday that Prime Minister Benjamin Netanyahu would overrule Ben-Gvir.
“The specific issue of prayer on the Temple Mount, in Al Aqsa, is currently still under discussion by the cabinet,” government spokesperson Avi Hyman said in a briefing on Thursday.
He added that a final decision would take security and public health, as well as the freedom of worship, into account.
A Ben-Gvir spokesperson did not respond to a request for comment. On Wednesday, Ben-Gvir posted on X that any attempt to override his authority would amount to a “capitulation to terror,” and urged Netanyahu to deny the Channel 12 report.


Two killed in Turkish drone strike on YBS fighters in northern Iraq

Updated 29 February 2024
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Two killed in Turkish drone strike on YBS fighters in northern Iraq

  • Two YBS fighters were in their vehicle in the Sinjar area when the drone strike hit them

MOSUL, Iraq: A Turkish drone strike in northern Iraq on Thursday killed two fighters from the Sinjar Resistance Units (YBS), a militia affiliated with the Kurdistan Workers Party (PKK), Iraqi security sources said.
Two YBS fighters were in their vehicle in the Sinjar area when the drone strike hit them, two security sources told Reuters.
There has been a long-running Turkish campaign in Iraq and Syria against militants of the PKK, YBS and the Syrian Kurdish YPG militia, which are all regarded as terrorist groups by Ankara.


Iran election seen as legitimacy test for rulers as dissent grows

Updated 29 February 2024
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Iran election seen as legitimacy test for rulers as dissent grows

  • Iran’s Supreme Leader Ayatollah Ali Khamenei called voting a religious duty
  • Parliament has no major influence on foreign policy or Iran’s nuclear agenda
DUBAI: Iran holds a parliamentary election on Friday seen as a test of the clerical establishment’s popularity at a time of growing dissent over an array of political, social and economic crises.
The vote will be the first formal gauge of public opinion after anti-government protests in 2022-23 spiralled into some of the worst political turmoil since the 1979 Islamic Revolution.
Critics from inside and outside the ruling elite, including politicians and former lawmakers, say the legitimacy of Iran’s theocratic system could be at stake due to economic struggles and a lack of electoral options for a mostly young population chafing at political and social restrictions.
Iran’s top authority, Supreme Leader Ayatollah Ali Khamenei, has called voting a religious duty. He accused the country’s “enemies” — a term he normally uses for the United States and Israel — of trying to create despair among Iranian voters.
The commander of the country’s elite Revolutionary Guards, Hossein Salami, said on Wednesday that “each vote is like a missile launched at the enemy’s heart.”
But Iranians still have painful memories of the handling of nationwide unrest sparked by the death in custody of a young Iranian-Kurdish woman in 2022, which was quelled by a violent state crackdown involving mass detentions and even executions.
Economic hardships pose another challenge. Many analysts say that millions have lost hope that Iran’s ruling clerics can resolve an economic crisis fomented by a combination of US sanctions, mismanagement and corruption.
While establishment supporters will likely vote for hard-line candidates, widespread public anger at worsening living standards and pervasive graft may keep many Iranians at home.
Prices for basic goods like bread, meat, dairy and rice have skyrocketed in past months. The official inflation rate stands at about 40 percent. Analysts and insiders put it at over 50 percent.
The US 2018 withdrawal from Iran’s 2015 nuclear deal with six world powers, and its reimposition of sanctions, have hit Iran’s economy hard. Efforts to revive the pact have failed.
Reformists shun ‘meaningless’ vote
Iranian activists and opposition groups are distributing the Twitter hashtags #VOTENoVote widely on social media, arguing that a high turnout will legitimize the Islamic Republic.
With heavyweight moderates and conservatives staying out of Friday’s race and reformists calling it an “unfree and unfair election,” the vote will pit hard-liners and low-key conservatives against each other, all proclaiming loyalty to Iran’s Islamic revolutionary ideals.
The interior ministry said 15,200 candidates will run for the 290-seat parliament, with a vetting body called the Guardian Council approving 75 percent of initially registered hopefuls.
The unelected Guardian Council, made up of six clerics and six legal experts generally within Khamenei’s orbit, has the authority to scrutinize laws and election candidates.
Ballots will mostly be counted manually, so the final result may not be announced for three days, although partial results may appear sooner.
On the same day, Iranians also vote for the Assembly of Experts, which appoints and can dismiss the supreme leader. The 88-member clerical body rarely intervenes directly in policy but is expected to help choose the 84-year-old Khamenei’s successor.
Parliament has no major influence on foreign policy or Iran’s nuclear agenda. These are determined by Khamenei who holds the utmost authority in the country’s unique dual system of clerical and republican rule.
Polling has projected turnover of about 41 percent, while former lawmaker Mahmoud Sadeghi said on Monday that surveys showed the participation could be as low as 27 percent, significantly lower than 42 percent in a 2020 parliamentary vote.
Discredited after years of failed attempts at widening political and social freedoms, the pro-reform opposition suffered further unpopularity in 2022 when protesters scorned its mantra of gradual change.
The Reform Front coalition has said it will not take part in the “meaningless” election but has not boycotted the vote.