title: Sleep habits in adolescents of Saudi Arabia; distinct patterns and extreme sleep schedules.
abstract: OBJECTIVE
  There is a need for comprehensive studies on adolescents' sleep habits in the Middle Eastern region. The aim of this study was to investigate the sleep-wake patterns, prevalence of excessive daytime sleepiness (EDS), and disturbed sleep among adolescents in Saudi Arabia and to identify the associated factors.
  
  
  METHODS
  The study was a cross-sectional survey done on a random sample of 1035 high school students, ages 14-23 years, in Jeddah, Saudi Arabia. The response rate was 91%. Students filled a self-reported questionnaire that included sleep-wake questions, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Perceived Stress Scale, academic performance, and personal data.
  
  
  RESULTS
  Students slept an average of 7.0 hours on school nights, with an average delay of 2.8 and 6.0 hours in weekend sleep and rise times, respectively. Around 1 in 10 students stayed up all night and slept after returning from school (exhibiting a reversed sleep cycle) on weeknights. This pattern was more prevalent among boys and students with lower grade point averages. The prevalence of sleep disturbance was 65%, and EDS was found in 37% of the students. Predictors of EDS were school type, stress, napping and caffeine use, while gender was a predictor of disturbed sleep.
  
  
  CONCLUSIONS
  Adolescents in Saudi Arabia showed a high percentage of poor sleep quality. Compared with adolescents from other countries, they had a larger delay in weekend sleep and rise times. An alarming reversed sleep cycle on weekdays is present and highlights the need for further assessment.
authors.affiliation: Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Roah A
authors.initials: RA
authors.lastname: Merdad
authors.affiliation: Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Leena A
authors.initials: LA
authors.lastname: Merdad
authors.affiliation: Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Rawan A
authors.initials: RA
authors.lastname: Nassif
authors.affiliation: Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Douaa
authors.initials: D
authors.lastname: El-Derwi
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University & Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Electronic address: sowali@kau.edu.sa.
authors.forename: Siraj O
authors.initials: SO
authors.lastname: Wali
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D012529:Saudi Arabia / Q000453:epidemiology; D012737:Sex Factors; D012890:Sleep; D012892:Sleep Deprivation / Q000453:epidemiology / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D055815:Young Adult
keywords: Adolescents; Epidemiology; Excessive daytime sleepiness; Saudi Arabia; Sleep disturbance; Sleep insufficiency; Sleep–wake patterns