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Is the Severity of Sleep Apnea Influenced by Race?

The common clinical profile for a patient with sleep apnea is an older male, overweight with a thick neck.  Nasal congestion, a small airway or throat, smoking, and alcohol consumption are also significant risk factors.  A new study published in the April issue of the Journal of Clinical Sleep Medicine suggests that race may be a factor in the severity of sleep apnea, for men in certain age ranges.

Investigating race and sleep apnea severity

DiverseIn their study, researchers analyzed the sleep study results of 512 participants (340 African-American, 172 Caucasian), looking for associations between outcomes and patient demographics.  They found that for African-American men younger than the age of forty, the AHI (Apnea-Hypopnea Index) figure was a little over 3 points higher than their Caucasian counterparts with a similar body mass index, meaning that the African-American men stopped breathing three more times per hour than the Caucasian men.  This figure dropped to a difference of 2.79 for those between the ages of 50 and 59.  Interestingly, there were no statistically important differences in AHI between African-American and Caucasian women.

These results came after performing statistical analysis on the collected data to investigate a variety of potential relationships between different factors, including gender, race, BMI, age, and other health conditions.

The significant of race in men’s airways

The researchers were not sure of a specific mechanism for why sleep apnea was  more severe in African-American males at certain ages, as compared to Caucasian males or why these differences were seen only in men, and not women.

Several reasons have been previously suggested for race being a risk factor for sleep apnea.  Physiological characteristics may be more prominent in one race over the other for example, the size and width of the tongue relative to the airway may make it easier for the airway to collapse or become obstructed.  Other suggested differences include neurochemical control of breathing, genetics, and cultural or environmental factors.

Obstructive sleep apnea is known to have a higher prevalence in African American children than Caucasian ones.  However, this may not be due to differences in  upper airway control mechanisms between races.  A 2011 study of 56 children ages 5-18 (28 African-American, 28 Caucasian) who were of normal weight with no snoring or sleep apnea symptoms found that airway collapsibility was similar between the two groups.

The presence of the male sex as a risk factor for sleep apnea is often explained by weight distribution:  men are more likely to carry excess weight around their stomach and chest, where it affects breathing by creating pressure that reduces breathing effort.  Women, on the other hand, often carry excess weight around their hips and lower waist where it is less likely to affect breathing during sleep.  It is possible these gender differences may help explain why the association between race and severity of sleep apnea was present in men, but not women.

Any person experiencing Sleep Apnea like symptoms, such as snoring, gasping for breath, or an observed cessation of breathing during sleep should contact a physician immediately, regardless of race or gender.

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