الفهرس 
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Abstract
Sleep health is a public health opportunity that has been underrecognized by both the sleep research and public health communities until recently.
This study has highlighted two findings:
• First, sleep health is critically important public health problem. It reported that more than 50 percent of the Egyptian adults is suffering from poor sleep quality. This high percentage of poor sleep quality is an alarming health problem needs to be addressed. Poor sleep quality affects daily activity, attention and the physical and mental health in general. Age and sex are nonmodifiable risk factors affecting the sleep quality among adults. Women have poorer sleep quality, longer sleep latency and more day time dysfunction. Aging is associated with shorter sleep duration and more sleep disturbances. Awareness of sociodemographic differences in sleep health can lead to the development and implementation of culturally and demographically sensitive interventions, as well as targeted provision of services to higher-risk populations.
• Second, this study obviously showed a relationship between poor sleep quality and short duration of sleep with higher likelihood of overweight/obesity in the adult population, whether a cause or a consequence, and must be considered in the overall prevention and treatment of obesity.
Obesity is a high prevalence public health issue in different age groups related with diverse negative health consequences among young and adults. Increased body weight has economic and social consequences besides the direct health effects. Studying the potential factors contributing to the high obesity prevalences has a big role on the health of population. The usual explanations of excess body weight have focused on dietary habits including the quality, and quantity of food consumed, availability of low-cost high-calorie foods and physical inactivity. Other causal mechanisms have been suggested, involving poor quality of sleep and chronic partial sleep loss.
Sleep is essential to our short- and long- term health. Suitable sleep is essential to be mentally, emotionally, and physically well. The quality, duration and timing of sleep can affect neurohormonal, metabolic, and endocrine functions. Obesity and sleep disorders are common adverse health problems, related to unhealthy behaviors and the two can co-exist frequently. Majority of studies examining the relation between sleep and obesity have examined mainly the effect of sleep duration on the body weight. However, assessing sleep involves both quantitative and qualitative aspects.
Research into sleep health of Egyptian adults is scanty, and therefore, relatively deficient local data are available. So, this is particularly needed to fill the gap. This would be helpful in developing clinical and public health information. from a public health perspective, modifiable risk factors, such as behavioral and environmental factors, are the most promising in terms of primordial prevention and control of obesity.
Objective: This research aimed to investigate sleep health to know the current situation in Egypt and to study the relationship between sleep quality, timing and sleep duration with body weight among adults.
Subjects and Methods: Community based nested case-control study carried out in Minia, Egypt. Sleep quality was assessed in 469 participants using the Pittsburgh Sleep Quality Index (PSQI). Sociodemographic data and anthropometric measures were collected. In addition to the physical activity questionnaire and food intake frequency to allow for controlling any possible confounding. The inclusion criteria included both sex, over the age of 18, and BMI >18.5. The exclusion criteria were any self-reported significant bodyweight change during the 6 months prior to the study, or self-reported significant change in sleep habits during the 6 months prior to the study, or patients with acute illness, Physical or mental disability.
Results: The studied group included 47.8% participants with normal BMI, while 31.8% were overweight and 20.5% were obese. Overweight/obese status were significantly more prevalent among the age group above 30 years old, rural subjects, married, housewives/professionals/office work and lower level of education.
Prevalence of poor sleep quality was (50.7%). Statistical significant effect of gender, marital status and level of education was reported; Poor sleepers were more among females, widow or divorced and among low level of education. Females have longer sleep latency than males i.e. they take more time to fall sleep, more sleep disturbances and more day time dysfunction compared to males.
The PSQI score was significantly higher among overweight/obese 6.113.05 than that of normal body weight subjects 5.582.64. Across the two studied BMI based groups; there was a statistically significant difference in each of duration of night sleep, sleep disturbances and timing of going to bed.
The global PSQI score has statistically significant correlation with sleep duration (r=-0.180), sleep latency (r=0.522) and the BMI (r=0.092). As well, duration of night sleep is significantly correlated with the BMI (r=-0.121) and the physical activity (r=-121).
Conclusion: This study has highlighted two findings. First, sleep health is critically important and underrecognized public health problem. About half of the adults in Egypt suffer from poor sleep quality. Second, this study obviously showed a relationship between poor sleep quality and short duration of sleep with higher likelihood of overweight/obesity in the adult population, whether a cause or a consequence, and must be considered in the overall prevention and treatment of obesity.
Recommendations: Improving sleep quality would constitute a simple and effective intervention to reduce the risk of obesity in the population. Assessing sleep quality and quantity should be considered in routine health care visits. Modifiable factors affecting sleep quality must be targeted, specifically in the vulnerable groups as women and older age groups, through sleep hygiene education and counseling for appropriate lifestyle and proper sleep practices. There is an urgent need for the introduction of multilevel strategies in which sleep health is addressed at the individual, provider, community, health system, and policy levels.