Prevalence of Obstructive Sleep Apnea in the Adult Population of Saudi Arabia: A Systematic Review and Meta-analysis.

Abstract

Background Obstructive sleep apnea (OSA) is a common but often overlooked disorder with profound cardiometabolic and neurocognitive consequences. Various studies in Saudi Arabia have reported varying prevalence figures. Objective To estimate the pooled prevalence of OSA among adults in Saudi Arabia. Methods The systematic review and meta-analysis were carried out between May and August 2025 according to PRISMA 2020 guidelines. Observational studies that described the prevalence of OSA among adults (≥16 years) were considered. Pooled prevalence was computed using a random-effect model with Freeman-Tukey transformation. I2 statistics were used to determine the heterogeneity. Subgroup analysis was undertaken according to population, diagnostic tool, size of the sample, and region. Results Thirty-three studies with 18,403 participants were included. The overall pooled prevalence of OSA was 26.96% (95% confidence interval [CI]: 20.98%-33.38%), with high heterogeneity (I 2 = 98.9%). This significant heterogeneity is primarily attributed to variations in study populations (general vs. high-risk) and the diverse diagnostic criteria employed across the included studies. The prevalence was 15.95% (95% CI: 11.80%-20.60%) in the general population and 42.60% (95% CI: 29.47%-56.27%) in high-risk groups. The diagnostic method influenced estimates, with polysomnography (34.1%) and STOP-BANG (33.8%) yielding higher prevalence than the Berlin Questionnaire (28.5%). Regional variation was observed, with higher prevalence in Riyadh compared to Mecca. Conclusions About one in four Saudi adults may have OSA, with prevalence markedly higher in high-risk groups. These findings underscore the need for national screening programs and targeted interventions to reduce the burden of undiagnosed OSA.