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.
* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.