Sleep Disorders and Obesity in Saudi Populations Across the Lifespan: A Systematic Review
Abstract
1. Introduction
2. Methodology
2.1. Search Strategy
2.2. Selection Criteria
2.3. Data Extraction
2.4. Strategy for Data Synthesis
2.5. Risk of Bias Assessment
3. Results
4. Discussion
4.1. Physiological Evidence and Mechanisms
4.2. Age-Specific Comparisons
5. Limitation
6. Implications
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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| Study | Design | City | Participants (n) | Mean Age (Years) | Age Group | Males n (%) |
|---|---|---|---|---|---|---|
| Alhusseini et al., 2021 [20] | Cross-sectional | Riyadh | 1113 | 18–45 | Adults | 327 (29.4) |
| Alshehri et al., 2019 [21] | Cross-sectional | Jeddah | 803 | 44.9 ± 15.9 | Adults | 454 (56.3) |
| Abedelmalek et al., 2022 [22] | Cross-sectional | Hail | 1598 | 12–15 | Children | 935 (55.8) |
| Alodhayani et al., 2017 [23] | Cross-sectional | Riyadh | 408 | 20.7 ± 2.3 | Young Adults | 224 (54.9) |
| Dabbour, 2020 [31] | Retrospective | Riyadh | 51 | 10.3 ± 2.3 | Children | 26 (51.0) |
| Al-Hazzaa et al., 2019 [24] | Cross-sectional | Riyadh | 1051 | 9.2 ± 1.7 | Children | 523 (49.8) |
| Alsulami et al., 2023 [33] | Cross-sectional | Jeddah | 659 | 18–30 | Young Adults | 313 (47.4) |
| Hassan et al., 2021 [25] | Cross-sectional | Madinah | 1528 | 9.7 ± 1.4 | Children | 842 (53.3) |
| BaHammam, 2015 [32] | Retrospective | Riyadh | 1693 | 47.7 ± 14.0 | Adults | 1076 (63.6) |
| Al-Hazzaa et al., 2012 [26] | Cross-sectional | Al-Khobar, Jeddah, Riyadh | 2868 | 16.6 ± 1.1 | Adolescents | 1379 (48.1) |
| Kabel et al., 2018 [27] | Cross-sectional | Taif | 1066 | 18–25 | Adolescents and young adults | 487 (45.7) |
| Al-Otaibi, 2016 [28] | Cross-sectional | Al-Hasa | 233 | 22.4 ± 9.6 | Young Adults | 0 |
| Rafique, 2023 [29] | Cross-sectional | Dammam | 1724 | 16–22 | Adolescents/Young Adults | 768 (44.5) |
| Mohieldein, 2020 [30] | Cross-sectional | Qassim | 81 | 18–46 | Adults | 59 (72.8) |
| Study | Population | Sleep Assessment | Key Outcomes | Evidence Strength * | ROBINS-I Bias Rating * |
|---|---|---|---|---|---|
| Alhusseini et al., 2021 [20] | General population | ** PSQI (Subjective) | Obesity, insomnia, and anxiety interrelate, worsening sleep and promoting emotional eating; poor sleep linked to obesity. | Moderate | Moderate |
| Alshehri et al., 2019 [21] | General population | PSG (Objective) | Obese individuals, especially men, show higher prevalence and severity of OSA; Class III obesity linked to severe OSA. | High | Low |
| Abedelmalek et al., 2022 [22] | Adolescents | ATLS (Subjective) | High obesity and overweight rates associated with diet, sleep, and activity; lifestyle modification recommended. | Moderate | Moderate |
| Alodhayani et al., 2017 [23] | Medical students | ESS (Subjective) | Sleep disruption associated with weight gain; sedentary reading and lying down post-lunch increase obesity risk. | Moderate | Moderate |
| Dabbour, 2020 [31] | Children | PSG (Objective) | Obesity is a risk factor for SDB; hypopnea most common, followed by OSA; BMI not correlated with OSA severity. | Moderate | Moderate |
| Al-Hazzaa et al., 2019 [24] | Children (6–13 yrs) | ATLS (Subjective) | Short sleep linked to male sex, low paternal education, infrequent breakfast, and long screen time; obesity not significant after adjustment. | High | Low |
| Alsulami et al., 2023 [33] | University students | ATLS (Subjective) | Obesity more prevalent in males (24%); predictors include male sex, short sleep, smoking, sugary drinks. | High | Low |
| Hassan et al., 2021 [25] | Children | PSQ (Subjective) | ~23% at risk for SDB; strong correlation between obesity/overweight and SDB risk. | Moderate | Moderate |
| BaHammam, 2015 [32] | General population | PSG (Objective) | OSA co-occurs with obesity hypoventilation syndrome; predictors include bicarbonate levels and oxygen saturation time. | High | Low |
| Al-Hazzaa et al., 2012 [26] | Adolescents (15–19 yrs) | ATLS (Subjective) | Short sleep duration is associated with overweight and obesity among teenagers. | Moderate | Moderate |
| Kabel et al., 2018 [27] | University students | ESS (Subjective) | Sleep disturbances and EDS are linked to anemia, obesity, glucose intolerance, and high altitude. | Moderate | Moderate |
| Al-Otaibi, 2016 [28] | General population | PSQI (Subjective) | Poor sleep associated with physical inactivity, high waist circumference, and obesity. | Moderate | Moderate |
| Rafique, 2023 [29] | General population | Online questionnaire (Subjective) | Short sleep duration is linked to higher BMI; sleep deprivation is an independent risk factor for obesity (OR 1.47). | High | Low |
| Mohieldein, 2020 [30] | General population | Self-reported (Subjective) | 7–8 h of sleep may reduce obesity risk; healthy sleep promotes better lifestyle choices. | Moderate | Moderate |
| Category | Children | Adolescents | Adults |
|---|---|---|---|
| Main Focus | Physiological effects of obesity on sleep, especially sleep-disordered breathing (SDB) | Behavioral and hormonal influences on sleep duration and weight status | Lifestyle, psychological stress, and chronic health outcomes linked to sleep and obesity |
| Common Sleep Problems | SDB, habitual snoring, short sleep duration | Irregular sleep schedules, poor sleep hygiene, delayed sleep phase | Insomnia, poor sleep quality, obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS) |
| Relationship to Obesity | Obesity increases SDB risk, but not always directly tied to short sleep | Short sleep duration strongly associated with overweight and obesity | Strong bidirectional association; poor sleep predicts higher BMI, weight gain, and metabolic dysfunction |
| Contributing Factors | High screen time, inconsistent sleep routines, family habits | Hormonal fluctuations, late-night device use, academic and social pressures | Sedentary behavior, stress, caffeine intake, unhealthy diet, long work hours, prolonged screen use |
| Gender Differences | Boys more prone to SDB | Males exhibit higher obesity rates and shorter sleep | Women more affected by OHS; stress and lifestyle contribute across genders |
| Health Implications | Respiratory issues, fatigue, reduced cognitive performance | Weight gain, mood disturbances, and decreased academic achievement | Hypertension, diabetes, metabolic syndrome, and depression |
| Recommended Interventions | Parental oversight, screen-time regulation, early SDB screening | Sleep education, stress reduction, promoting consistent routines | Workplace wellness programs, stress management, sleep hygiene promotion |
| Overall Insight | Sleep–obesity link primarily driven by physiological mechanisms | Behavioral and hormonal disruptions reinforce obesity risk | Complex metabolic and psychosocial feedback loops sustain obesity and poor sleep |
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Aljohani, A.H.; Aljohani, A.H.; Alshammari, K.M. Sleep Disorders and Obesity in Saudi Populations Across the Lifespan: A Systematic Review. J. Clin. Med. 2025, 14, 8709. https://doi.org/10.3390/jcm14248709
Aljohani AH, Aljohani AH, Alshammari KM. Sleep Disorders and Obesity in Saudi Populations Across the Lifespan: A Systematic Review. Journal of Clinical Medicine. 2025; 14(24):8709. https://doi.org/10.3390/jcm14248709
Chicago/Turabian StyleAljohani, Amal H., Abdullah Heliel Aljohani, and Khalid Mohammed Alshammari. 2025. "Sleep Disorders and Obesity in Saudi Populations Across the Lifespan: A Systematic Review" Journal of Clinical Medicine 14, no. 24: 8709. https://doi.org/10.3390/jcm14248709
APA StyleAljohani, A. H., Aljohani, A. H., & Alshammari, K. M. (2025). Sleep Disorders and Obesity in Saudi Populations Across the Lifespan: A Systematic Review. Journal of Clinical Medicine, 14(24), 8709. https://doi.org/10.3390/jcm14248709

