Leng Yue, Cavaillès Clémence, Peltz Carrie, O'Bryant Sid E, Redline Susan, Yaffe Kristine
Department of Psychiatry and Behavioral Sciences and.
San Francisco Veterans Affairs Health Care System, San Francisco, California.
Ann Am Thorac Soc. 2025 Sep;22(9):1401-1408. doi: 10.1513/AnnalsATS.202411-1146OC.
Racial and ethnic and sex differences in sleep may exist, but limited data directly compare objective estimates of obstructive sleep apnea (OSA), particularly in rapid eye movement (REM) versus non-REM (NREM) sleep, among Black, Mexican American and non-Hispanic White (NHW) adults. To determine whether OSA parameters during REM and NREM sleep differ by race, ethnicity, or sex in community-dwelling adults. The DORMIR study conducted a comprehensive sleep examination among Black, Mexican American, and NHW adults 50 years of age and older enrolled in the ongoing HABS-HD (Health and Aging Brain Study-Health Disparities) cohort (2020-2024). Here we characterize racial, ethnic, and sex differences in OSA indices assessed by a U.S. Food and Drug Administration-approved peripheral arterial tonometry-based home sleep testing system. We examined 821 participants (mean age, 66.6 ± 8.5 yr), including 543 (66.1%) women, 284 (34.6%) Mexican American individuals, and 174 (21.2%) Black individuals. About half (50.5%) had moderate to severe OSA as defined by the respiratory event index (REI; based on 3% desaturations of ≥15 events/h), 72.7% with REM-REI ≥ 15 events/h, and 39.5% with NREM-REI ≥ 15 events/h. Significant racial, ethnic, and sex differences were observed for REM-specific but not overall OSA metrics. Black women had the highest REM-REI, and NHW men had the lowest REM-REI. After controlling for demographics, socioeconomic factors, comorbidities, and sleep medication use, Black participants had a REM-REI 3 events/h higher than NHW adults, and NREM-REI values were similar. Mexican American individuals had similar REM or NREM OSA parameters compared with NHW adults but exhibited higher average blood oxygen concentrations. In this new, diverse cohort, peripheral arterial tonometry-based measures of in-home sleep indicate more REM-stage respiratory events in Black adults, particularly Black women, compared with their NHW counterparts. Given the link between REM OSA and adverse health outcomes, clinicians should pay more attention to this sleep apnea phenotype, especially in minoritized populations.
睡眠方面可能存在种族、族裔和性别差异，但直接比较阻塞性睡眠呼吸暂停（OSA）客观评估数据的研究有限，尤其是在黑人、墨西哥裔美国人和非西班牙裔白人（NHW）成年人中，比较快速眼动（REM）睡眠与非快速眼动（NREM）睡眠中的OSA情况。为了确定社区居住成年人中REM和NREM睡眠期间的OSA参数是否因种族、族裔或性别而异。DORMIR研究对正在进行的HABS-HD（健康与衰老大脑研究-健康差异）队列（2020 - 2024年）中50岁及以上的黑人、墨西哥裔美国人和NHW成年人进行了全面的睡眠检查。在此，我们描述了通过美国食品药品监督管理局批准的基于外周动脉张力测定的家庭睡眠测试系统评估的OSA指数中的种族、族裔和性别差异。我们检查了821名参与者（平均年龄66.6±8.5岁），其中包括543名（66.1%）女性、284名（34.6%）墨西哥裔美国人以及174名（21.2%）黑人。约一半（50.5%）的人根据呼吸事件指数（REI；基于≥15次/小时的3%血氧饱和度下降）被定义为患有中度至重度OSA，72.7%的人REM-REI≥15次/小时，39.5%的人NREM-REI≥15次/小时。在特定于REM的OSA指标而非总体OSA指标中观察到了显著的种族、族裔和性别差异。黑人女性的REM-REI最高，NHW男性的REM-REI最低。在控制了人口统计学、社会经济因素、合并症和睡眠药物使用情况后，黑人参与者的REM-REI比NHW成年人高3次/小时，而NREM-REI值相似。与NHW成年人相比，墨西哥裔美国人的REM或NREM OSA参数相似，但平均血氧浓度较高。在这个新的、多样化的队列中，基于外周动脉张力测定的家庭睡眠测量表明，与NHW成年人相比，黑人成年人，尤其是黑人女性，在REM阶段的呼吸事件更多。鉴于REM OSA与不良健康结果之间的联系，临床医生应更多地关注这种睡眠呼吸暂停表型，尤其是在少数族裔人群中。
