Abstract
The South Asian population is at increased risk of cardiovascular disease. We compared the prevalence and severity of obstructive sleep apnea (OSA) in South Asians and white Europeans with severe obesity. Data from consecutive patients attending a specialist weight management service were analyzed. Self-reported age, gender, and ethnicity were recorded. Objective measurements of blood pressure, body mass index (BMI), and apneahypopnea index (AHI) were also acquired. A total of 308 patients (72.7% women; 13% South Asian) were included, with mean age and BMI of 46 ± 12 y and 49 ± 8 kg/m2, respectively. South Asians had significantly increased prevalence of OSA compared to white Europeans (85% vs. 66% [p = 0.017]) and were more likely to have severe OSA (42.5% vs. 21.6% [p = 0.015]). South Asians had significantly higher median AHI (24 events/h: interquartile range [IQR] 9.3-57.6 vs. 9 events/h: IQR 3.4-26.6; p < 0.01), significantly lower minimum oxygen saturation (76%: IQR 64% to 84% vs. 83%: IQR 77% to 87%; p < 0.01), and spent a significantly greater amount of time < 90% oxygen saturation (8.4%: IQR 1.0% to 24.3% vs. 2.4%: IQR 0.2% to 16.0%; p = 0.03). South Asian ethnicity, independent of demographics, BMI, and comorbidities, was associated with β = 1.84 (95% CI: 1.27-2.65) increase in AHI+1 compared to white Europeans. Furthermore, we confirmed other independent OSA risk factors including increasing age, BMI, and male gender (all p < 0.001). Severely obese South Asians had significantly greater prevalence and severity of OSA than white Europeans. OSA may contribute to increased cardiovascular risk in South Asians compared to white Europeans with severe obesity. Mechanisms mediating the observed associations between these ethnicities require further investigation.
Highlights
Obstructive sleep apnea (OSA) is a common disorder characterized by frequent episodes of complete or partial upper airway obstruction during sleep, with subsequent oxygen desaturation, and sleep disturbance
Based on the evidence that South Asians have a higher prevalence of metabolic and cardiovascular morbidities, we hypothesized that severely obese South Asians would have a higher prevalence and more severe obstructive sleep apnea (OSA) than white Europeans
Our results demonstrate South Asians have a significantly greater prevalence of OSA with more severe OSA compared to white Europeans
Summary
Obstructive sleep apnea (OSA) is a common disorder characterized by frequent episodes of complete or partial upper airway obstruction during sleep, with subsequent oxygen desaturation, and sleep disturbance. Compared to white Europeans, South Asians (those of Indian/ Pakistani/Bangladeshi/Sri Lankan origin) residing in western countries, have a higher prevalence of type 2 diabetes, dyslipidemia, and CVD.[9] Considering these conditions commonly accompany OSA, it is possible that South Asians are at greater risk of OSA than white Europeans. This potential ethnic difference has not, been comprehensively examined, in the severely obese. Based on the evidence that South Asians have a higher prevalence of metabolic and cardiovascular morbidities, we hypothesized that severely obese South Asians would have a higher prevalence and more severe OSA than white Europeans
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
