Purpose To evaluate the presence of obstructive sleep apnea (OSA), using home sleep testing in pilots and first officers in Saudi-based airlines. This will allow for proper diagnosis and management of OSA in that group which can help in minimizing any possible aviation accidents related to sleep disturbances secondary to OSA. Materials and Methods This is a cross-sectional study conducted through Saudi-based aviation among pilots and first officers who were in service, active, and flying short- to medium-haul flights. Forty-one participants met the inclusion criteria. However, 39 out of 41 completed the study questionnaires (Berlin questionnaire, Epworth sleepiness scale, Pittsburgh sleep quality index (PSQI), Fatigue severity scale (FSS), Visual analog fatigue scale (VAFS), and Patient health questionnaire (PHQ9), along with home sleep testing. Results Sixty-nine percent of the study population had OSA by home sleep testing. Majority of which had mild OSA (64%) and 5% had moderate and severe OSA (2.5% each). Results of different questionnaires showed one-third of the participants had insomnia, 33.3% of the participants had severe fatigue, excessive daytime sleepiness was found in 23.1% of the participants, and 10.3% had moderate depression, while 25.6% were classified as having mild depression symptoms. Conclusion Sleep apnea is prevalent among the studied Saudi-based airline pilots and first officers. Screening for workers of this high-risk occupation needs to be considered. Fatigue, depression, and insomnia can be secondary consequences of sleep apnea and should be assessed and treated early.

Purpose Positional obstructive sleep apnoea (POSA) is of important clinical significance, as positional treatment can augment or obviate continuous positive airway pressure. This study aimed to determine the prevalence of POSA and its characteristics using different definitions. Methods We retrospectively examined a cohort of patients who underwent polysomnography (PSG) between 2013 and 2019 at two sleep centres. Demographic data and PSG data were collected from 624 patients with an apnoea–hypopnea index (AHI) ≥ 5. POSA was defined using different criteria as follows: (1) AHI of at least twice as high in the supine position as in the lateral position (Cartwright’ s definition). (2) A supine AHI ≥ 10 and a lateral AHI < 10 (Marklun’s definition). (3) AHI of at least twice as high in the supine position than in the lateral position, with the lateral AHI not exceeding 5 (Mador’s definition or Exclusive POSA; e-POSA). (4) AHI ≥ 15/h; a supine AHI ≥ twice that of the nonsupine AHI ≥ 20 min of sleep in the supine and nonsupine positions; and a nonsupine AHI < 15 (Bignold’s definition). Results The prevalence of POSA was 54% (Cartwright), 38.6% (Mador), 33.8% (Marklund) and 8.3% (Bignold). Multivariate regression analysis showed a body mass index (BMI) < 35 kg/m2 was the only significant predictor of POSA. Mador’s definition had the highest diagnostic yield (sensitivity 63%; specificity 100%; area under the receiver operating characteristic curve 90.2%). Conclusion POSA is common, but its prevalence depends on the definition used. Low BMI was identified as a significant predictor.

OBJECTIVE: Sleep problems during the coronavirus disease 2019 (COVID-19) pandemic commonly affected general populations. Data on the effect of the COVID-19 pandemic on sleep quality in Saudi Arabia are scarce. Thus, the aim of our study was to evaluate sleep quality and assess the psychological burden of the pandemic in COVID-19 patients and the general population. METHODS: This was a multicenter, observational, cross-sectional survey. Participants with COVID-19 were recruited from different health-care centers in the western region during the lockdown period from May 13, 2020 to September 2, 2020. All participants completed a validated online survey. The control group comprised individuals from the general public who responded to the online survey through social media. Demographic data, COVID-19 status, and history of chronic diseases were collected. Sleep quality, depression, and insomnia were assessed using validated questionnaires. Results: In total, 1091 participants were surveyed and 643 (58.9%) were positive for COVID-19. Poor sleep quality was reported in 66.1% of COVID-19 patients (mean score ± standard deviation [SD] 6.9 ± 4.0) and 72.8% of controls (mean score ± SD 7.6 ± 4.3). Insomnia affected 50.5% of COVID-19 patients (mean score ± SD 6.5 ± 5.5) and 58.5% of controls (mean score ± SD 7.6 ± 5.5). Depression was diagnosed in 39.5% of COVID-19 patients (mean score ± SD 4.7 ± 4.6) and 70.1% of controls (mean score ± SD 8.9 ± 6.7). CONCLUSIONS: The COVID-19 pandemic had a great impact on mental health and sleep quality in both COVID-19 patients and the general population but more pronounced in the general population.