High prevalence of poststroke sleep-disordered breathing in Mexican Americans

Abstract

ObjectiveThe purpose of this study is to compare sleep-disordered breathing (SDB) prevalence and severity after stroke between Mexican Americans (MAs) and non-Hispanic whites (NHWs). Patients/methodsIschemic stroke (IS) patients within ∼30 days of onset were identified from the population-based BASIC Project (2010–2014) and offered screening with an overnight cardiopulmonary monitoring device, ApneaLink Plus™. The number of apneas and hypopneas per hour, as reflected by the apnea/hypopnea index (AHI), was used to measure SDB severity; SDB was defined as AHI ≥10. Ethnicity, demographics, and risk factors were collected from interviews and medical records. Log and negative-binomial regression models were used to determine prevalence ratios (PRs) and apnea/hypopnea event rate ratios (RRs) comparing MAs with NHWs after adjustment for demographics, risk factors, and stroke severity. ResultsA total of 549 IS cases had AHI data. The median age was 65 years (interquartile range (IQR): 57–76), 55% were men, and 65% were MA. The MAs had a higher prevalence of SDB (68.5%) than NHWs (49.5%) in unadjusted (PR = 1.38; 95% confidence interval (CI): 1.14–1.67) and adjusted analyses (PR = 1.21; 95% CI: 1.01–1.46). The median AHI was 16 (IQR: 7–31) in MAs and nine (IQR: 5–24) in NHWs. The severity of SDB (rate of apneas/hypopneas) was higher in MAs than NHWs in unadjusted (RR = 1.31; 95% CI: 1.09–1.58) but not adjusted analysis (RR = 1.14; 95% CI: 0.95–1.38). There was no ethnic difference in severity among subjects with SDB. ConclusionMore than two-thirds of MA stroke patients had SDB, which was almost 40% more common among MAs than NHWs. Physicians treating MA patients after stroke should have a high index of suspicion for SDB, a treatable condition that could otherwise have adverse impact.