The impact of ethnicity on the prevalence and severity of obstructive sleep apnea

Abstract

Obstructive sleep apnea (OSA) is a common disorder associated with multiple adverse health consequences and its prevalence is increasing in parallel with rising obesity trends. Early support for ethnic differences in OSA prevalence and severity has been derived from studies of relatively homogenous ethnic groups. However, between-study comparisons are problematic given differing methodologies. Recent large inter-ethnic studies examining different ethnic populations using standardized protocols support the notion that Chinese have an increased OSA prevalence and severity compared to those of European descent. Although the evidence is less clear, some data suggest that Hispanic/Mexican Americans also show higher rates of OSA, while OSA prevalence in African Americans is not dissimilar to that of populations of European ancestry. Of the anatomical traits underlying differences in OSA prevalence and severity between ethnic groups (i.e., obesity, fat distribution, and craniofacial structure) obesity appears to be the most important. The effect of ethnicity on non-anatomical factors (i.e., upper airway muscle responsiveness, arousal threshold, and loop gain) responsible for OSA severity and potentially prevalence is currently unknown and needs further research.

Polysomnographic phenotyping of obstructive sleep apnea and its implications in mortality in Korea

“…A longer follow up period or perhaps prospective multicenter studies, with more detailed clinical information may overcome these limitations. In addition, this is a single center study mainly composed by a Korean population, therefore, generalization should be avoided as ethnic factors such as diet, craniofacial morphological differences, obesity, and prevalence of comorbidities are known to be different from Western countries 51 , 52 . Finally, K-means clustering may not be the optimal clustering algorithm for the current dataset.…”

<p>Gender Differences in the Clinical and Polysomnographic Characteristics Among Australian Aboriginal Patients with Obstructive Sleep Apnea</p>

“… 4 – 7 Moreover, individual’s ethnicity and gender is considered to represent one of the important phenotype variants in the clinical manifestations of patients with OSA. 8 , 9 Furthermore, OSA has been assumed to be a male predominant disease and most of our knowledge on OSA comes largely from male population-based studies. However, it is being increasingly recognised among women and the male-to-female ratio is estimated to be between 2:1 and 3:1.…”

“…Published studies on ethnic and gender differences in the clinical manifestation of OSA has mostly come from populations involving Caucasians, African Americans, and Hispanics. 8 , 9 , 18 - 20 However, worldwide approximately 370 million people are estimated to be of Indigenous descent and live in over 90 countries and are thought to make up for about 5% of the global population. 21 , 22 In Australia, 3.3% of the population are considered to be of Aboriginal and Torres Strait Islander (ATSI) origin.…”

Sleep Status and the Risk Factor of Drowsy-Related Accidents in Commercial Motor Vehicle Drivers

“…This discrepancy may be due to the small sample size in terms of statistical analysis. Recent large inter-ethnic studies using standardized protocols support the notion that Chinese or Asian men have an increased OSA prevalence and severity compared to those of European descent [38][39][40]. Selection bias based on self-selection of participants in our study may also play a role in this result.…”