沙特阿拉伯的睡眠医学：演变、当前格局与未来方向——一项最新进展综述，并嵌入对卫生部睡眠中心2022至2025年的卫生服务分析

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中文摘要

背景： 沙特阿拉伯的睡眠医学已从20世纪90年代末的一个单一学术实验室发展为一项新兴的国家服务。这一发展是在阻塞性睡眠呼吸暂停（OSA）负担沉重且仍被低估、公众认知度低，以及国家对预防、可及性、道路安全和价值导向医疗日益关注的背景下展开的。
目的： 描述沙特阿拉伯睡眠医学的演变和当前格局，记录2022至2025年期间实施的卫生部（MOH）国家睡眠医学项目，并对照“2030愿景”优先事项和国际基准解读剩余的服务缺口。
方法： 我们开展了一项最新进展叙述性综述，并对常规收集的MOH集群睡眠中心报表进行了生态学卫生服务分析。操作数据集包括8个集群的26个集群-年份观察值和41项标准化指标。我们使用计数、比例、人口调整率以及复合年增长率（CAGR，定义为（期末值/期初值）∧(1/年数)减1）来总结趋势。采用Spearman秩相关探讨基础设施、人力资源与产出之间的关联，并列时采用中秩赋值处理。一个容量-需求缺口模型在基准情形和敏感性情形下估计了年度诊断需求。项目里程碑与MOH文件、沙特卫生专业委员会（SCFHS）记录、沙特流行病学研究、AASM标准以及WHO和OECD报告进行了三角互证。
结果： 2022至2025年间，活跃的MOH睡眠中心从5个增至8个。PSG床位容量从8张增至20张（CAGR 35.7%），年度睡眠检查产出从2,290例增至5,851例（CAGR 36.7%）。2025年儿科实验室PSG为557例，占实验室活动的17%。人力资源增长滞后于基础设施（CAGR 14.9%）；MOH睡眠医师密度达到每百万服务人口0.42名，远低于已报告的国际比例。该项目交付了国家总体规划、虚拟健康医院睡眠门诊、准备度手册、MOH对8个中心的分类、公立和私营部门监管框架、一项交通安全提案、公众宣传活动以及一次国家培训工作坊。在基准情形下（成人OSA患病率12%、成人人口比例65%、年度诊断捕获率5%），MOH网络满足了估计年度需求的约4%；敏感性情形产生的覆盖范围约为3%至11%。CPAP积压与完成比率为7:1，PSG等待时间在各中心间相差68倍。
结论： 沙特睡眠医学已迅速从学术亚专科转变为全国性组织的服务。下一阶段应从单纯的基础设施扩张转向学习型卫生系统模式，围绕国家睡眠登记、人力资源规划、集中化PAP采购与依从性支持、标准化分诊，以及与慢性病、职业健康和道路安全项目的整合来构建。

英文摘要

BACKGROUND: Sleep medicine in Saudi Arabia has developed from a single academic laboratory in the late 1990s into an emerging national service. That development has played out against a heavy and still under-recognized burden of obstructive sleep apnea (OSA), low public awareness, and rising national attention to prevention, access, road safety, and value-based care.
OBJECTIVE: To describe the evolution and current landscape of sleep medicine in Saudi Arabia, document the Ministry of Health (MOH) National Sleep Medicine Program delivered during 2022 to 2025, and interpret remaining service gaps against Vision 2030 priorities and international benchmarks.
METHODS: We conducted a state-of-the-art narrative review and an ecological health-services analysis of routinely collected MOH cluster sleep-center returns. The operational dataset included 26 cluster-year observations across eight clusters and 41 standardized indicators. We summarized trends using counts, proportions, population-adjusted rates, and the compound annual growth rate (CAGR) defined as (ending value / beginning value)∧(1/years) minus 1. Spearman rank correlations explored associations between infrastructure, workforce, and output, with ties handled by mid-rank assignment. A capacity-to-demand gap model estimated annual diagnostic need under base-case and sensitivity scenarios. Program milestones were triangulated against MOH documents, Saudi Commission for Health Specialties (SCFHS) records, Saudi epidemiologic studies, AASM standards, and WHO and OECD reports.
RESULTS: Active MOH sleep centers grew from five to eight between 2022 and 2025. PSG bed capacity rose from 8 to 20 (CAGR 35.7%), and annual sleep-study output increased from 2,290 to 5,851 (CAGR 36.7%). Pediatric in-lab PSG accounted for 557 studies in 2025, or 17% of in-lab activity. Workforce growth lagged infrastructure (CAGR 14.9%); MOH sleep-physician density reached 0.42 per million served population, far below reported international ratios. The Program delivered a national master plan, a Virtual Health Hospital sleep clinic, a readiness manual, MOH classification of eight centers, public- and private-sector regulatory frameworks, a traffic-safety proposal, public-awareness activity, and a national training workshop. Under the base case (12% adult OSA prevalence, 65% adult-population fraction, 5% annual diagnostic capture), the MOH network met about 4% of estimated annual need; sensitivity scenarios produced a coverage range of roughly 3 to 11%. The CPAP backlog-to-fulfillment ratio was 7:1, and PSG wait times varied 68-fold across centers.
CONCLUSIONS: Saudi sleep medicine has moved quickly from an academic subspecialty to a nationally organized service. The next phase should shift from infrastructure expansion alone to a learning health-system model built around a national sleep registry, workforce planning, centralized PAP procurement and adherence support, standardized triage, and integration with chronic-disease, occupational-health, and road-safety programs.