Sleep Disordered Breathing in Hispanic/Latino Individuals of Diverse Backgrounds: The Hispanic Community Health Study/Study of Latinos.

American Journal of Respiratory and Critical Care Medicine (Impact Factor: 11.99). 01/2014; 189(3). DOI: 10.1164/rccm.201309-1735OC
Source: PubMed

ABSTRACT Rationale: Hispanic/Latino populations have a high prevalence of cardiovascular risk factors and may be at risk for sleep disordered breathing (SDB). An understanding of SDB among these populations is needed given evidence that SDB increases risk of cardiovascular risk. Objectives: To quantify SDB prevalence in the U.S. Hispanic/Latino population and its association with symptoms, risk factors, diabetes and hypertension; explore variation by sex and Hispanic/Latino background. Methods: Cross-sectional analysis from the baseline examination of the Hispanic Community Health Study / Study of Latinos. Measurements: The apnea hypopnea index (AHI) was derived from standardized sleep tests; diabetes and hypertension based on measurement and history. Main Results: The sample of 14,440 individuals had an age-adjusted prevalence of minimal SDB (AHI≥5), moderate SDB (AHI ≥15) and severe SDB (AHI≥ 30) of 25.8%, 9.8%, and 3.9%, respectively. Only 1.3% of participants reported a sleep apnea diagnosis. Moderate SDB was associated with being male (adjusted odds ratio 2.7; 95% CI: 2.3, 3.1); obese (16.8; 11.6, 24.4); and older. SDB was associated with an increased adjusted odds of impaired glucose tolerance (1.7; 1.3, 2.1), diabetes (2.3; 1.8, 2.9) and hypertension. The association with hypertension varied across background groups with the strongest associations among individuals of Puerto Rican and Central American background. Conclusions: SDB is prevalent in U.S. Latinos but rarely associated with a clinical diagnosis. Associations with diabetes and hypertension suggest a large burden of disease may be attributed to untreated SDB, supporting the development and evaluation of culturally relevant detection and treatment approaches.

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    ABSTRACT: We evaluated the association between obstructive sleep apnea (OSA) and neurocognitive function among community-dwelling Hispanic/Latino individuals in the United States. Cross-sectional analysis of the Hispanic Community Health Study/Study of Latinos middle-aged and older adults, aged 45 to 74 years, with neurocognitive test scores at baseline measurements from 2008 to 2011. Neurocognitive scores were measured using the Word Fluency (WF) Test, the Brief-Spanish English Verbal Learning Test (SEVLT), and the Digit Symbol Substitution (DSS) Test. OSA was defined by the apnea-hypopnea index (AHI). Multivariable linear regression models were fit to evaluate relations between OSA and neurocognitive scores. The analysis consisted of 8,059 participants, mean age of 56 years, 55% women, and 41% with less than high school education. The mean AHI was 9.0 (range 0-142; normal AHI <5/h). There was an association between the AHI and all 4 neurocognitive test scores: Brief-SEVLT-sum (β = -0.022) and -recall (β = -0.010), WF (β = -0.023), and DSS (β = -0.050) at p < 0.01 that was fully attenuated by age. In the fully adjusted regression model, female sex was a moderating factor between the AHI and WF (β = -0.027, p < 0.10), SVELT-sum (β = -0.37), SVELT-recall (β = -0.010), and DSS (β = -0.061) at p < 0.01. OSA was associated with worse neurocognitive function in a representative sample of Hispanic/Latino women in the United States. © 2014 American Academy of Neurology.
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    ABSTRACT: Portable sleep monitors may offer a convenient method to expand detection of obstructive sleep apnea (OSA), yet few studies have evaluated this technology in vulnerable populations. We therefore aimed to assess the feasibility and acceptability of portable sleep monitors for detection of OSA in a prediabetic, urban minority population. We recruited a convenience sample of participants at their 12-month follow-up for a community-partnered, peer-led lifestyle intervention aimed to prevent diabetes in prediabetic and overweight patients in this prospective mixed-methods pilot study. All participants wore portable sleep monitors overnight at home. We qualitatively explored perceptions about OSA and portable monitors in a subset of participants. We tested 72 people, predominantly non-White, female, Spanish speaking, uninsured, and of low income. Use of portable sleep monitors was feasible: 100% of the monitors were returned and all participants received results. We detected OSA in 49% (defined as an Apnea-Hypopnea Index [AHI] >5) and moderate-severe OSA in 14% (AHI >15) requiring treatment in 14%. In 21 qualitative interviews, participants supported increased use of portable sleep monitors in their community, were appropriately concerned that OSA could cause progression to diabetes, and thought weight loss could prevent or improve OSA. Portable sleep monitors may represent a feasible method for detecting OSA in high-risk urban minority populations. © Copyright 2015 by the American Board of Family Medicine.


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Feb 11, 2015