Sleep medicine service in Saudi Arabia A quantitative assessment Ahmed S. BaHammam, FRCP, FCCP , Bandar AlJafen, MBBS. S leep medicine is a relatively new specialty; however, over the past 25 years this ield has expanded and developed in order to diagnose and treat diferent sleep-related disorders. he latest international classiication of sleep disorders (ICSD) included more than 84 disorders. 1 As a result, the number of clinical sleep facilities (SFs) needed to diagnose and treat patients with sleep disorders has increased worldwide. he interest in developing clinical SFs has increased with the recognition of obstructive sleep apnea (OSA) and its complications. For accurate diagnosis of OSA and proper initiation of therapy, the patient needs to spend at least one night in the sleep laboratory for an overnight sleep study (polysomnography [PSG]). Polysomnography remains the gold standard diagnostic test for OSA and an essential part of the diagnosis of other sleep disorders such as narcolepsy and movement disorders. 2 During the study, diferent physiological parameters are monitored and recorded continuously by a trained sleep technician. If the patient was diagnosed to have OSA, continuous positive airway pressure (CPAP) trial is attempted where the pressure of CPAP is titrated gradually under PSG monitoring to reach the optimal pressure that will eliminate the obstructive events and improve sleep architecture. Patients with OSA can be evaluated in the SF for an entire diagnostic night followed by a CPAP titration night; or a split- night protocol can be used, where a single split-night study for diagnosis and CPAP titration is performed. 3 Objective assessment of daytime sleepiness in the SF is performed using standardized tests. he most commonly used tests are the multiple sleep latency test (MSLT) and the wakefulness maintenance test (MWT). 4 he American Academy of Sleep Medicine (AASM) described 2 diferent types of sleep disorders facilities. Sleep disorders center (SDC) is a medical facility providing clinical diagnostic services and treatment for patients who present with symptoms or features that suggest the presence of any sleep disorder; 477 ABSTRACT Objective: To assess quantitatively sleep medicine services in Saudi Arabia (KSA) and identify obstacles that face specialists and hospitals and preclude the establishment of this service. Methods: A self-administered questionnaire was mailed to 53 major governmental and private hospitals in KSA on September 2005. he response rate was 69.8%. Data were coded and analyzed. Results: he survey identiied 9 sleep disorders facilities in KSA; 7 were deined as sleep disorders centers and 2 as sleep laboratory using the American Academy of Sleep Medicine deinitions. he per capita polysomnography (PSG) rate was 7.1 PSG/year/100,000 population, which was much lower than the reported rates in developed countries. he occupancy rate of sleep facilities was found to be low (45.7%). he most important identiied obstacles facing the progress of sleep medicine in KSA were lack of trained sleep technicians, shortage of sleep medicine specialists and the un-availability of fund or designated space for the facility. Conclusion: Sleep medicine seems to be underdeveloped in KSA compared to developed countries. Organized eforts are needed to overcome the identiied obstacles and challenges facing the progress of sleep medicine in KSA. Saudi Med J 2007; Vol. 28 (6): From the Sleep Disorders Center, Respiratory Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. Received 18th November 2006. Accepted 11th February 2007. Address correspondence and reprint request to: Prof. Ahmed BaHammam, Director Sleep Disorders Center, Department of Medicine 38, College of Medicine, King Saud University, PO Box 225503, Riyadh 11324, Kingdom, of Saudi Arabia. Tel. +966 (1) 4671521. Fax. +966 (1) 4672558. E-mail: ashammam2@yahoo.com, ashammam2@gmail.com Original Articles