Prevalence of Sleep Apnea in Four Arab Countries (Egypt, Jordan, Iraq, and Oman): A Systematic Review and Meta-Analysis.

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with cardiovascular, metabolic, and psychological complications. Data on its prevalence in Arab countries remain scarce. This study aimed to estimate the pooled prevalence of OSA in Egypt, Jordan, Oman, and Iraq, and to explore sources of heterogeneity.

METHODS

A systematic search of major scientific databases was conducted to identify studies up to 2025. Pooled prevalence was calculated using a random-effects model and Heterogeneity was assessed. Subgroup analyses were performed by country and diagnostic tool, and meta-regression examined temporal trends. Publication bias was evaluated with Egger's and Begg's tests, and adjusted using the trim-and-fill method.

RESULTS

Fifty studies with 58 prevalence estimates involving 881,184 participants were included. The pooled prevalence of OSA was 33.0% (95% CI: 28.3%-37.8%), with marked heterogeneity (I2 = 99.8%). Subgroup analysis showed higher prevalence in Egypt (39%) compared with Jordan (28%) and other Arab countries (24%). No significant differences were observed between diagnostic tools, and heterogeneity persisted across subgroups. Meta-regression revealed no significant change in prevalence over time. Evidence of small-study effects was found; after trim-and-fill adjustment, the pooled prevalence rose to 37.1%.

CONCLUSION

OSA prevalence in Arab countries is higher than in many Western populations, representing a significant public health concern. The persistent heterogeneity and stable prevalence suggest that risk factors such as obesity, sedentary lifestyle, and genetic predisposition remain unchanged. These findings underscore the need for targeted prevention, systematic screening, and improved diagnostic standards to reduce the disease burden.