OSA more prevalent in Black, Native Americans, less prevalent in Asians

Key takeaways:

• This study population was divided into six racial/ethnic groups.
• OSA prevalence went up with age.
• Native Hawaiian/Pacific Islanders also had increased OSA prevalence depending on age and sex.

BOSTON — Black and Native American adults had elevated prevalences of obstructive sleep apnea vs. non-Hispanic white adults, and Asian adults had a low prevalence, according to data presented at the CHEST Annual Meeting.

“These findings emphasize the importance of screening for OSA in primary care practice, with special attention to screening asymptomatic adults in racial and ethnic groups with higher OSA prevalence, including those identified in this study,” Jimmy H. Yao, MD, internal medicine resident at Kaiser Permanente Oakland Medical Center, told Healio. “Protocols may need to be developed for Asian adults, who are less likely to be screened for OSA due to their lower BMI.”

In this study, Yao and colleagues evaluated 2,740,587 adults in Northern California via 2016 electronic health record data to discover how OSA prevalence differs when divided into several racial/ethnic groups.

This study population included 1,140,114 non-Hispanic white adults, 496,578 Asian adults, 398,814 Latino adults, 164,829 Black adults, 16,667 Native Hawaiian/Pacific Islander adults and 15,765 Native American adults.

Notably, the Asian total cohort was made up of 142,751 Chinese adults, 141,987 Filipino adults, 91,804 South Asian adults, 66,409 Southeast Asian adults, 23,186 Japanese adults, 15,124 Korean adults and 15,317 adults of other/unknown Asian ethnicity.

“There has been little research into the prevalence of OSA among Asian and Native Hawaiian and Pacific Islander adults and how prevalence differs across Asian ethnic groups,” Yao told Healio.

As non-Hispanic white men grew older, researchers found that the prevalence increased from 4.7% at ages 25 to 44 years, to 11.7% at 45 to 64 years and then to 14.7% at 65 to 85 years.

This pattern was also seen in the group of Native American men but with greater prevalence percentages than the non-Hispanic white men. In the youngest age group, the prevalence of OSA was 6.1%, which grew to 15.9% in the 45-to-64-year group and to 20.4% in the oldest age group.

Other male racial/ethnic groups that had larger OSA prevalences vs. non-Hispanic white men included Black men (25-44 years, 6.2%; 45-64 years, 13.3%) and Native Hawaiian/Pacific Islander men (25-44 years, 8%; 45-64 years, 13.6%).

Researchers continued to find that OSA prevalence went up with age when assessing women.

For non-Hispanic white women, prevalence grew from 2% in the 25- to 44-year-old group, to 6.5% in the 45- to 64-year-old group and to 8.5% in the 65- to 85-year-old group.

Similar to the groups of men, three female racial/ethnic groups had larger prevalences of OSA vs. non-Hispanic white women: Native American women in each age range (25-44 years, 3.9%; 45-64 years, 9.6%; 65-85 years, 11.3%), Black women in each age range (25-44 years, 3.7%; 45-64 years, 9.7%; 65-85 years, 11.1%) and Native Hawaiian/Pacific Islander women in the 25-to-44-year-old group (2.6%).

Within the Asian cohort, the group with the highest OSA prevalence in the 25-to-44-year-old range was Filipino men (6.3% vs. 3.1%-4%) and Filipino women (2.1% vs. 0.8%-1.2%), according to the abstract.

In the 45- to 64-year-old range, Filipino women also had the greatest prevalence (5% vs. 2.1%-4.1%), whereas for men, researchers observed the largest prevalences in Japanese and Filipino men (10.4% and 9.8% vs. 4.7%-7.4%).

“Among older adults [65 years and older], OSA prevalence among Japanese men and Chinese and South Asian adults approached that of Filipino adults,” Yao told Healio.

“Higher OSA prevalence among Filipino and especially Native Hawaiian/Pacific Islander adults compared to Chinese and other Asian groups is in line with the higher prevalence of obesity, diabetes and hypertension that we’ve seen in these populations,” Yao added.

Looking ahead, Yao told Healio that future studies may evaluate OSA risk factors across Asian ethnic groups.

“These findings underscore the importance of disaggregating the Asian and Native Hawaiian and Pacific Islander populations when examining health outcomes,” Yao said.

“As screening rates for OSA are increasing due to greater awareness of the effects of untreated OSA, we expect that the prevalence of diagnosed OSA will also increase,” Yao added. “Risk factors for OSA may differ among Asian ethnic groups and should also be examined.”

For more information:

Jimmy H. Yao, MD, can be reached through susan.l.rochman@kp.org.