Background and objective:
Medical students appear to experience high-level academic load and clinical duties and are a high-risk population for sleep disorders (SDs). Multiple sleep disturbances have been identified among medical students in the Middle East and North Africa (MENA) countries. However, the SD epidemiology is still unclear. Quantifying SD proportion in medical students and assessing the associated factors can help inform the development of targeted interventions to reduce SDs. Our objective is to synthesize SD prevalence and assess associated factors among medical students in MENA countries.

Methods:
PubMed, Web of Science, Google Scholar, and reference lists of relevant studies were searched by two independent reviewers for grey and non-grey relevant literature. Studies reporting SD prevalence with or without associated factors among medical students in any MENA country were included. Meta-analyses were performed using random-effects models.

Results:
Twenty-two studies were included in the meta-analysis (n=19,955, mean age±SD [range: 20.5±1.67 to 23.1±3.8 years]; sample size [range: 122 to 1,041]). Hypersomnolence was the most prevalent SD [prevalencepooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia [prevalencepooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm disorders [prevalencepooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], breathing-related sleep disorders [prevalencepooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalencepooled range: 5.9% (Egypt)to 30.6% (Saudi Arabia)], and parasomnias [prevalencepooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. SD were associated with female sex, studying in the senior years of medical school, anxiety, excessive internet use, and poor academic performance.

Conclusion:
SDs are prevalent among MENA medical students. Further investigation is required to understand SDs for which there is limited data. Public health interventions that are culturally appropriate to the local context of the academic setting are necessary to mitigate SDs and improve the health, well-being, safety, and productivity of MENA medical students.