Agarwal Sanjana, Monsod Paige, Cho Yoon-Sik, MacRae Sharon, Swierz Justyna S, Healy William J, Kwon Younghoon, Liu Xiaoyue, Cho Yeilim
Education and Clinical Center, VISN 20 Mental Illness Research, Seattle, WA, USA.
University of Washington, Seattle, WA, USA.
Curr Sleep Med Rep. 2024 Dec;10(4):414-418. doi: 10.1007/s40675-024-00308-6. Epub 2024 Jun 24.
Racial disparities in sleep health as well as the diagnosis and treatment of sleep disorders have emerged as a key driver of cardiovascular outcomes. Obstructive sleep apnea (OSA), is characterized by repeated airway obstructions during sleep and is associated with an increased risk of cardiovascular disease. While racial and ethnic minorities have disproportionately high OSA prevalence rates, diagnosis rates remain low. One explanation behind this phenomenon are structural environmental and lifestyle barriers that prevent access to OSA care. Additionally, there remains significantly limited understanding of OSA and its causes and symptoms within communities.
In general, minorities have poorer sleep health due to systemic and environmental racism, which also causes an increased in conditions such as obesity that increases OSA risk. Disparities also persist within various types of OSA treatment. The most common form of treatment, continuous positive airway pressure (CPAP) has lower adherence among African Americans, as well as those living in areas with low socioeconomic status (SES), primarily minorities. There have been a small number of studies that have shown some initial success of educational campaigns about OSA within minority communities in increasing screenings and diagnoses. Peer based education has been an effective technique, and there is a need for such programs to be expanded.
Disparities persist, with minority groups having worse sleep health and lower rates of adherence to OSA treatment. Some grassroots, peer-led educational campaigns show promise in increasing adherence. In light of these disparities, there remains a need for the field of sleep medicine to continue addressing the systemic barriers that hinder the timely evaluation and treatment in racial minorities.
睡眠健康方面的种族差异以及睡眠障碍的诊断和治疗已成为心血管疾病结局的关键驱动因素。阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间反复出现气道阻塞，并与心血管疾病风险增加相关。虽然少数族裔的OSA患病率过高，但诊断率仍然很低。这种现象背后的一个原因是阻碍获得OSA治疗的结构性环境和生活方式障碍。此外，社区内对OSA及其病因和症状的了解仍然非常有限。
总体而言，由于系统性和环境种族主义，少数族裔的睡眠健康状况较差，这也导致肥胖等疾病增加，从而增加了OSA风险。不同类型的OSA治疗中也存在差异。最常见的治疗形式，持续气道正压通气（CPAP）在非裔美国人以及生活在社会经济地位（SES）较低地区的人群（主要是少数族裔）中依从性较低。有少数研究表明，在少数族裔社区开展的关于OSA的教育活动在增加筛查和诊断方面取得了一些初步成功。基于同伴的教育是一种有效的技术，需要扩大此类项目。
差异仍然存在，少数群体的睡眠健康状况较差，OSA治疗的依从率较低。一些基层的、由同伴主导的教育活动在提高依从性方面显示出了希望。鉴于这些差异，睡眠医学领域仍有必要继续解决阻碍对少数族裔进行及时评估和治疗的系统性障碍。
