Racial and Ethnic and Sex Differences in At-Home Estimates of Obstructive Sleep Apnea Parameters among Diverse Adults

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-rapid eye movement (NREM) sleep, among Black, Mexican American and non-Hispanic White 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 non-Hispanic White adults aged 50 years and older enrolled in the ongoing Health and Aging Brain Study-Health Disparities cohort (2020-4). Here we characterize racial, ethnic, and sex differences in OSA indices assessed by an FDA-approved Peripheral Arterial Tonometry (PAT)-based home sleep testing system. We examined 821 participants (mean age=66.6±8.5 years), including 543 (66.1%) females, and 284 (34.6%) Mexican American and 174 (21.2%) Black individuals. Around half (50.5%) had moderate-to-severe OSA as defined by the respiratory event index (REI based on 3% desaturations of ≥15/hour), 72.7% with REM-REI≥15/hour and 39.5% with NREM-REI≥15/hour. Significant racial, ethnic, and sex differences were observed for REM-specific but not overall OSA metrics. Black females had the highest REM-REI, and NHW males had the lowest REM-REI. After controlling for demographics, socioeconomic factors, comorbidities, and sleep medication use, Black participants had a REM-REI 3 events/hour higher than NHW adults, while NREM-REI were similar. Mexican American individuals had similar REM or NREM OSA parameters compared to non-Hispanic White adults but exhibited higher average blood oxygen levels. In this new, diverse cohort, PAT-based measures of in-home sleep indicate greater REM-stage respiratory events in Black adults, particularly Black females, compared to their non-Hispanic White 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. Primary Source of Funding: National Institute on Aging.