Mental Health, Sleep, and Physical Activity Among Young Saudi Women During Ramadan: A Comparative Cohort Study

This study investigated mental health outcomes of young adult women in relation to physical activity and sleep patterns before, during, and after Ramadan.

A prospective repeated-measures cohort study was conducted in the Department of Physical Therapy at Jazan University, Saudi Arabia. Healthy women aged 18-30 years were recruited through convenience sampling, with exclusions for chronic illness, pregnancy, lactation, psychological disorders, or recent hospitalization. Self-reported data were collected online at three time points: before Ramadan, during Ramadan, and after Ramadan. The study assessed physical activity using the International Physical Activity Questionnaire-Short Form, sleep quality using the Pittsburgh Sleep Quality Index, and emotional states using the Depression, Anxiety, and Stress Scale-21.

Thirty young adult females participated in the study. Physical activity showed a gradual increase, with significant improvements from pre-Ramadan to Ramadan (p =0.039) and from pre-Ramadan to post-Ramadan (p =0.009). Sleep was significantly disrupted during Ramadan, with shorter duration (p <0.001) and poorer global sleep quality (p =0.002), followed by marked improvement post-Ramadan (all pairwise p ≤.001). Stress levels peaked during Ramadan and declined significantly afterward (p =0.010), whereas depression and anxiety remained stable across all phases (p >0.05). Regression analyses showed that poorer sleep quality significantly predicted higher depression, anxiety, and stress before and during Ramadan (all p ≤.002), but not after Ramadan. Physical activity and BMI were not associated with mental health outcomes.

The study found that while depression and anxiety stayed stable across the Ramadan periods, stress decreased after Ramadan. Sleep quality consistently related to mental health, whereas increased physical activity during Ramadan showed no link to emotional well-being. Overall, sleep and stress emerged as the key factors influencing well-being throughout the Ramadan cycle.