0440 Peripheral arterial tonometry–based measures of obstructive sleep apnea in Black, Mexican American and non-Hispanic White adults

Abstract

Abstract Introduction Racial/ethnic differences may exist in sleep quality and disorders, but there are limited data directly comparing objective measures of obstructive sleep apnea (OSA) among Black, Mexican American (MA) and non-Hispanic White (NHW) populations. Methods To date, the ongoing Health & Aging Brain among Latino Elders (HABLE)-Dormir study has enrolled 761 participants using a community-based participatory research approach. Here we describe OSA indices assessed by in-home assessments using WatchPAT, a Peripheral Arterial Tonometry (PAT)-based home sleep testing system that is validated for the diagnosis of OSA. Results Participants had a mean age of 65.6+/-8.2 (50-90) years, comprised of 64% women; 34% MA, 24% Black and 42% NHW adults. Over half (52.0%) of the participants had moderate or more severe OSA as defined by the respiratory event index (REI based on 3% desaturations) of >=15/hour, 73.1% with REM-OSA (REM-REI >=15/hour) and 40.6% with NREM-OSA (NREM-REI >=15/hour). The median of the average snoring volume through the night was 41 (40-61) dB. The median percentage of sleep time spent with oxygen saturation below 90% (SpO2< 90%) was 1.0%. After adjustment for age, sex, Body Mass Index, cognitive status, and history of hypertension, diabetes, stroke and heart attack, Black and MA participants were 71% and 55% more likely to have REM-OSA compared to NHW participants (p=0.04), but had similar prevalence of NREM-OSA (p=0.80) and overall OSA (p=0.32). The adjusted mean percentage of sleep time spent with over 40dB snoring volume was higher among Black (22.7%, p=0.03) and MA adults (21.2%, p=0.11) than NHW adults (18.5%). The adjusted mean prevalence of nocturnal hypoxemia (SpO2< 90% time >= 1%) was similar among Black (48.2%), MA (51.7%) and NHW (50.0%) adults; p=0.83. Conclusion In this middle-to-older-aged population, PAT-based measures of OSA indicate a higher prevalence in minoritized adults of REM-specific sleep apnea, a phenotype associated with increased rates of hypertension and mortality. Home-based measures that do not distinguish between REM and NREM respiratory events may underestimate sleep apnea in these groups. Support (if any) This research was supported by National Institutes of Health grant R01AG066137.