Perceived Changes in Psychological Well-Being, Cognitive Domains, and Sleep Quality Among Jordanian Adults Observing Ramadan Intermittent Fasting: A Prospective Cohort Study.
11 affiliations
- 1Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan.
- 2Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, Al Ain P.O. Box 64141, United Arab Emirates.
- 3Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Applied Science Private University, Amman 11937, Jordan.
- 4Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Philadelphia University, Amman 19392, Jordan.
- 5Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan.
- 6Department of Nutrition and Food Technology, Faculty of Agriculture, Mu'tah University, Karak 61710, Jordan.
- 7Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan.
- 8Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University, Salt 19117, Jordan.
- 9Nutrition and Dietetics Department, Faculty of Health Sciences, American University of Madaba, Madaba 11821, Jordan.
- 10Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates.
- 11Department of Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates.
Abstract
Background and Aims: Ramadan intermittent fasting (RIF) involves significant shifts in sleep patterns and circadian rhythms that may affect neurological health. This study aimed to evaluate changes in neuropsychiatric and neurocognitive functions in relation to sleep quality among healthy adults observing RIF. Methods: We recruited healthy adults from various regions in Jordan for this prospective cohort study. We used validated self-report questionnaires to assess mental health and sleep parameters. Anxiety and depression were assessed using the GAD-7 and PHQ-9, respectively. We measured resilience using the 10-item Nicholson McBride Resilience Questionnaire (NMRQ), and the Neuro-QoL (cognitive functions domain) assessed memory and attention. We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We administered all tools before (BR) and at the end of Ramadan (DR) to track changes in symptom severity and functional status. Results: A total of 723 healthy adults (mean age: 28.82 ± 12.04 years) completed both assessments. A paradoxical divergence emerged between mood and sleep parameters: mean scores for depression (PHQ-9: 8.65 to 7.70) and anxiety (GAD-7: 6.75 to 5.65; both p = 0.0001) improved significantly, with a higher proportion of participants reporting minimal symptoms during Ramadan. Conversely, overall sleep quality (PSQI) deteriorated markedly, with the percentage of participants classified as having "good sleep quality" dropping from 66.4% to 34.9% (p = 0.0001). While sleep latency and sleep disturbances improved slightly, subjective sleep quality and sleep duration worsened significantly (p ≤ 0.01). Additionally, Neuro-QoL cognitive scores decreased from 30.60 to 28.97 (p = 0.0001), whereas total resilience scores remained stable (p = 0.897). Conclusions: RIF is associated with significant improvements in depression and anxiety scores despite a concurrent deterioration in overall sleep quality and duration. While these findings suggest a favorable impact on subjective mental well-being, the observational design precludes establishing causal relationships. This paradoxical interplay between fasting-induced mood enhancements and sleep disruptions highlights the need for future prospective studies utilizing objective measurement tools.
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BibTeX
@article{alkurd2026perceived,
title = {{Perceived Changes in Psychological Well-Being, Cognitive Domains, and Sleep Quality Among Jordanian Adults Observing Ramadan Intermittent Fasting: A Prospective Cohort Study.}},
author = {Refat Ahmad Fawzi Alkurd and Narmeen Jamal Al-Awwad and Maysoun S Qutob and Hani J Hamad and Asma'a Albakri and Mohammed O Ibrahim and Hadeel Soboh and Husam Khraiwesh and Fadwa Hammouh and Dana N Abdelrahim and Hamid Aldeen Alhaj and MoezAlIslam E Faris},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/healthcare14193148},
url = {https://europepmc.org/article/MED/42881586},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perceived Changes in Psychological Well-Being, Cognitive Domains, and Sleep Quality Among Jordanian Adults Observing Ramadan Intermittent Fasting: A Prospective Cohort Study.
AU - Refat Ahmad Fawzi Alkurd
AU - Narmeen Jamal Al-Awwad
AU - Maysoun S Qutob
AU - Hani J Hamad
AU - Asma'a Albakri
AU - Mohammed O Ibrahim
AU - Hadeel Soboh
AU - Husam Khraiwesh
AU - Fadwa Hammouh
AU - Dana N Abdelrahim
AU - Hamid Aldeen Alhaj
AU - MoezAlIslam E Faris
PY - 2026
DA - 2026/09/22
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193148
UR - https://europepmc.org/article/MED/42881586
AB - Background and Aims: Ramadan intermittent fasting (RIF) involves significant shifts in sleep patterns and circadian rhythms that may affect neurological health. This study aimed to evaluate changes in neuropsychiatric and neurocognitive functions in relation to sleep quality among healthy adults observing RIF. Methods: We recruited healthy adults from various regions in Jordan for this prospective cohort study. We used validated self-report questionnaires to assess mental health and sleep parameters. Anxiety and depression were assessed using the GAD-7 and PHQ-9, respectively. We measured resilience using the 10-item Nicholson McBride Resilience Questionnaire (NMRQ), and the Neuro-QoL (cognitive functions domain) assessed memory and attention. We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We administered all tools before (BR) and at the end of Ramadan (DR) to track changes in symptom severity and functional status. Results: A total of 723 healthy adults (mean age: 28.82 ± 12.04 years) completed both assessments. A paradoxical divergence emerged between mood and sleep parameters: mean scores for depression (PHQ-9: 8.65 to 7.70) and anxiety (GAD-7: 6.75 to 5.65; both p = 0.0001) improved significantly, with a higher proportion of participants reporting minimal symptoms during Ramadan. Conversely, overall sleep quality (PSQI) deteriorated markedly, with the percentage of participants classified as having "good sleep quality" dropping from 66.4% to 34.9% (p = 0.0001). While sleep latency and sleep disturbances improved slightly, subjective sleep quality and sleep duration worsened significantly (p ≤ 0.01). Additionally, Neuro-QoL cognitive scores decreased from 30.60 to 28.97 (p = 0.0001), whereas total resilience scores remained stable (p = 0.897). Conclusions: RIF is associated with significant improvements in depression and anxiety scores despite a concurrent deterioration in overall sleep quality and duration. While these findings suggest a favorable impact on subjective mental well-being, the observational design precludes establishing causal relationships. This paradoxical interplay between fasting-induced mood enhancements and sleep disruptions highlights the need for future prospective studies utilizing objective measurement tools.
SN - 2227-9032
ER -