The Impact of Ramadan Fasting on Sleep and Treatment Compliance in Psychiatric Patients: A Survey Study.

Background: During Ramadan, fasting is a duty for all healthy adult Muslims. During this month, there is a major and abrupt break in chrono-biological rhythms, sleep duration and timing, and the activity/rest cycle. Aims: This study aims to explore the impact of the month of Ramadan, with its various biological, behavioral, and social repercussions, on mental health in Tunisian psychiatric patients who may or may not be fasting. Objective: To determine the impact of the month of Ramadan on sleep and treatment compliance in psychiatric patients. Methods: This was a survey study of all patients under follow-up at the Monastir psychiatric outpatient department for mental disorders, with two measurements during and after the month of Ramadan in 2019 (i.e., from May 05 to June 04, 2019, the number of hours of fasting in Tunisia was between 15h 43 min and 16 h 36 min). The data was analyzed in 2020. Results: After studying 107 survey responses twice, during and after Ramadan, this study shows that sleep quality was significantly impaired during Ramadan for both fasters and non-fasters. There was also a significant difference between Ramadan and post-Ramadan in terms of treatment compliance; hence, adherence to treatment in the study population depended on the Ramadan effect and not the Fasting effect. Conclusion: This study showed that sleep quality assessed by the ISI insomnia scale was significantly impaired during the month of Ramadan for both fasting and non-fasting subjects. Also, adherence to treatment in the study population depended on the Ramadan effect and not the fasting effect.