Abstract
Examine the distribution of symptoms and risk factors, and estimate the prevalence of obstructive sleep apnea (OSA) among Māori and non-Māori New Zealanders. Mail-out survey to a stratified random sample from the electoral roll of 10,000 people aged 30-59 y, and overnight MESAM IV monitoring during sleep of a similarly aged stratified random sample of 364 people from the Wellington electoral roll. Nationwide survey of OSA symptoms (71% response rate) and regional home-based measurement of respiratory disturbance index (RDI, 4% oxygen desaturations/h of sleep, plus bursts of snoring or > or = 10/min increase in heart rate). Sample designs aimed for equal numbers of Māori and non-Māori participants, men and women, and participants in each decade of age. N/A. Māori were more likely than non-Māori to report OSAS risk factors and symptoms. After controlling for sex and age, Māori were 4.3 times more likely to have RDI > or = 15 (95% CI = 1.3-13.9). Ethnicity was not an independent risk factor after controlling for body mass index (BMI) and neck circumference. The prevalence of OSAS (RDI > or = 5 and ESS > 10) was conservatively estimated to be 4.4% for Māori men, 4.1% for non-Māori men, 2.0% for Māori women, and 0.7% for non-Māori women. The national survey and the regional monitoring study indicate a higher prevalence of OSA among Māori and among men. The higher prevalence among Māori appears to be attributable to recognized risk factors, notably body habitus. In addition to increased prevention and treatment services, strategies are needed to reduce ethnic disparities in OSAS prevalence.
Highlights
Introductionobstructive sleep apnea syndrome (OSAS) is one of the most commonly diagnosed sleep disorders internationally and is estimated to affect 2% of women and 4% of men.[5] The prevalence of OSAS has been extensively researched, but most studies include populations with a limited socioeconomic range and reflect majority ethnic groups, and are limited in their ability to examine ethnic inequalities.[6] Differences in prevalence of OSAS by ethnicity are important for furthering the understanding of this syndrome, and to inform the prevention and delivery of appropriate diagnostic and treatment services to address any inequalities
Improvements have been seen in Māori health status over the decades, compared to other New Zealanders, major disparities still remain in almost all health indicators including those which are commonly comorbid with obstructive sleep apnea syndrome (OSAS), such as hypertension, heart disease, and stroke.[7,8,9]
The only significant interaction found was between ethnicity and smoking status as risk factors for reporting witnessed apneas
Summary
OSAS is one of the most commonly diagnosed sleep disorders internationally and is estimated to affect 2% of women and 4% of men.[5] The prevalence of OSAS has been extensively researched, but most studies include populations with a limited socioeconomic range and reflect majority ethnic groups, and are limited in their ability to examine ethnic inequalities.[6] Differences in prevalence of OSAS by ethnicity are important for furthering the understanding of this syndrome, and to inform the prevention and delivery of appropriate diagnostic and treatment services to address any inequalities. The first study surveyed the distribution of OSAS symptoms and risk factors in a representative national sample of Māori and non-Māori aged 30-59 years, and the second measured pathophysiological indices of OSA during sleep in a random sample of Māori and non-Māori aged 30-59 years in the Wellington region
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