Sleep Duration and Quality, Sleep Disorders and Their Association with Adiposity Markers in Adults from the Middle...

Middle Eastern and North African (MENA) populations face a high burden of metabolic syndrome; however, the potential associations between poor sleep and adiposity remain unexplored in these groups. To address this gap, the present systematic review evaluated the correlations between sleep duration, sleep quality, sleep disorders (specifically, obstructive sleep apnea [OSA] and insomnia) and markers of adiposity. Unlike Western cohorts, MENA populations may exhibit distinct circadian-dietary phenotypes shaped by nighttime social engagement and religiously driven sleep fragmentation.

We conducted a systematic search of the literature on April 2, 2025, across four databases: PubMed, Scopus, Web of Science, and Embase. Data were synthesized narratively because of heterogeneity in study designs and outcome measures.

Our screening identified 517 studies, of which 10 (primarily cross-sectional) met the inclusion criteria. Poor sleep quality was disproportionately prevalent in women (up to 77% vs 49% in men). Subjective sleep duration (<6-7 hours) was associated with higher odds of excessive weight (OR=1.55-1.60), whereas actigraphy-verified sleep metrics were inversely correlated with BMI. Insomnia symptoms or disorders were observed in up to 50% of women and 35% of men, although no significant associations were found between insomnia and adiposity measures. OSA prevalence ranged from 6.1% in general population samples to 71% in clinical cohorts. Severe OSA was driven by increased neck circumference (OR=1.26, 95% CI: 1.09, 1.45) and waist circumference (OR=1.06, 95% CI: 1.02, 1.10). Sex-specific associations remain uncertain, as only a few of the included studies conducted stratified analyses.

Cross-sectional associations between poor sleep and markers of adiposity have been observed, although the sparse literature and lack of longitudinal, objective data preclude any causal inferences. Whether MENA women are more vulnerable than men to poor sleep and subsequent adiposity remains unknown, but this is plausible considering their disproportionate obesity rates. The synthesis of current evidence exposes literature gaps that necessitate longitudinal research to clarify the magnitude and directionality of these metabolic risks.