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Background: Sleep disturbance is one of the major problems schizophrenic patients' faces that worsen their symptoms and lead to serious morbidities and even increased mortality. We assessed the sleep quality and associated factors among schizophrenic patients. Methods: We conducted a crosssectional study using interviews of patients with questionnaires. Using the Pittsburgh Sleep Quality Index (PSQI) and Morisky Green test (MGT), we assessed sleep quality and antipsychotic medication adherence, respectively.Results: We enrolled 377 participants who were mostly male (76.7%), Saudi nationals (93.4%) and unemployed (79.3%), with a mean age of 36.38 ±10.59 years. The mean age of diagnosis of schizophrenia was 24.8± 8.30 years. Most earned less than 3,000 Saudi riyals (SAR) per month (77.5%) and were using two or more medications (92.3%). The majority (82%) of participants scored > 5 on the PSQI, indication poor quality of sleep (PSQI score > 5), while (18%) had good quality of sleep (PSQI score < 5) and more respondents with a poor sleep were significantly male (p=0.018), < 3000 SAR/ month earners (p = 0.006) and unemployed (p=0.001). Only female gender was a significant independent predictor for poor sleep quality (AOR=2.21, 95% CI: 1.00-4.88) (p=0.048) of all Participants 72.3% were not adhering to their medications. Conclusion: We found poor sleep quality among participants with poor adherence to medications, indicating the necessity for measures to help them have good sleep quality by addressing factors identified in order to ensure successful care outcomes.

Background: Musculoskeletal pain is a major burden on individuals, social and healthcare systems. Annually, 2–3 million pilgrims perform the Hajj in Mecca, Saudi Arabia. The Hajj involves a high level of physical demand because pilgrims generally move by foot for long distances among a series of religious sites, an effort that may exceed the typical physical activity level for most individuals. To understand the impact of musculoskeletal pain on the completion of the Hajj, it is first necessary to evaluate the extent of the problem. This study aimed to estimate the point prevalence of musculoskeletal pain and associated risk factors among pilgrims. Methods: A cross-sectional survey was conducted during the period of the Hajj. Data were collected after completion of the 2 nd day of the Hajj (21–31 August 2018), mainly by volunteers using an online application or paper form and approaching individuals at different sites around Mecca. The main inclusion criteria were as follows: adult pilgrims aged 18 or older. Participants were allowed to report more than one site of pain. Prevalence and odds ratios were calculated. Results: A total of 1,715 responses were included in the data analysis. The prevalence of musculoskeletal pain was high (82.27%). Musculoskeletal pain was most commonly reported in the ankle/foot (39.07%), leg (30.38%), lower back (28.40%), knee (23.03%) and shoulder (16.09%). The odds ratios revealed that musculoskeletal pain was more common in females; older individuals; individuals who smoked, had diabetes or hypertension; those who believed that the Hajj was physically exhausting and those who had experienced a fall during the Hajj. However, there were variations in the degrees of importance of these factors across different anatomical sites of the pain. Conclusions: Musculoskeletal pain is common among pilgrims, and it is more prevalent among pilgrims than among the general population. Unlike most populations examined in other studies, ankle/foot and leg pain were the most common in pilgrims. These data provide guidance for potential preventative programs and the allocation of resources to optimise pilgrims’ experiences and ability to complete the Hajj. Trial registration: The study was registered at https://www.researchregistry.com in August 2018 (No. 4352).