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美国原住民/太平洋岛民阻塞性睡眠呼吸暂停患者的严重程度、合并症和治疗依从性。

Severity, comorbidities, and adherence to therapy in Native Hawaiians/Pacific Islanders with obstructive sleep apnea.

机构信息

University of Utah, Department of Internal Medicine, Division of Pulmonary and Critical Care, Salt Lake City, Utah.

Division of Hematology, Department of Medicine, Salt Lake City, Utah.

出版信息

J Clin Sleep Med. 2023 May 1;19(5):967-974. doi: 10.5664/jcsm.10472.

Abstract

STUDY OBJECTIVES

Considerable disparities in the prevalence, diagnosis, and management of obstructive sleep apnea (OSA) exist for minority groups in the United States. However, the impact of OSA on Native Hawaiian/Pacific Islanders (NHPIs) has not been evaluated.

METHODS

We performed a retrospective review of patient records of NHPIs who underwent sleep apnea testing between 2014 and 2021 at a single center in Utah to characterize the distribution of comorbidities, disease severity, and treatment adherence.

RESULTS

140 of 141 NHPI patients who underwent sleep testing had OSA. High rates of obesity (94%) and other relevant comorbidities were found. OSA was mostly severe (57%), particularly in males with higher obesity. Adherence to continuous positive airway pressure was low (41% using for 4 or more hours on 70% of nights), and medical factors predicted whether adherence targets were met with modest accuracy (area under the curve 0.699).

CONCLUSIONS

NHPIs at a single sleep center had a high prevalence of comorbidities in association with OSA, a skewed distribution toward severe disease suggestive of barriers to care or unique disease characteristics, and low adherence to continuous positive airway pressure. These findings suggest a high burden of OSA in this population, and further work to characterize barriers to identifying and treating OSA in NHPIs can improve chronic disease outcomes in NHPIs.

CITATION

Locke BW, Sundar DJ, Ryujin D. Severity, comorbidities, and adherence to therapy in Native Hawaiians/Pacific Islanders with obstructive sleep apnea. . 2023;19(5):967-974.

摘要

研究目的

在美国,少数民族群体中阻塞性睡眠呼吸暂停(OSA)的患病率、诊断和治疗存在相当大的差异。然而,尚未评估 OSA 对夏威夷原住民/太平洋岛民(NHPIs)的影响。

方法

我们对 2014 年至 2021 年期间在犹他州的一家单一中心接受睡眠呼吸暂停测试的 NHPIs 患者的病历进行了回顾性审查,以描述合并症、疾病严重程度和治疗依从性的分布情况。

结果

在接受睡眠测试的 141 名 NHPIs 患者中,有 140 名患有 OSA。发现肥胖症(94%)和其他相关合并症的发生率很高。OSA 大多很严重(57%),尤其是肥胖程度较高的男性。持续气道正压通气的依从性较低(41%的患者在 70%的夜间使用 4 个小时或更长时间),并且医疗因素可以适度准确地预测是否达到了依从性目标(曲线下面积为 0.699)。

结论

在单一睡眠中心,NHPIs 患有 OSA 的合并症患病率较高,疾病严重程度呈偏态分布,表明存在治疗障碍或疾病特征独特,以及持续气道正压通气的依从性较低。这些发现表明该人群中 OSA 的负担很高,进一步努力描述识别和治疗 NHPIs 中 OSA 的障碍,可以改善 NHPIs 的慢性疾病结局。

引用

Locke BW, Sundar DJ, Ryujin D. 阻塞性睡眠呼吸暂停患者的严重程度、合并症和对持续气道正压通气的依从性。睡眠医学。2023;19(5):967-974.

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