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Sleep Apnea Severity in Black Patients May Be Underestimated Using Standard Tests

Authors say findings show the need to test the accuracy of oximeters across diverse populations

By Lori Solomon HealthDay Reporter

TUESDAY, May 30, 2023 (HealthDay News) — Obstructive sleep apnea (OSA) tests may underestimate the severity of OSA in Black patients, according to a study presented at the American Thoracic Society’s 2023 International Conference, held from May 19 to 24 in Washington, D.C.

Ali Azarbarzin, Ph.D., from Harvard Medical School in Boston, and colleagues examined the extent to which severity of episodic desaturations during sleep varies by racial/ethnic groups after accounting for severity of ventilatory deficit and several confounders. Analysis included 1,955 participants from the Multi-Ethnic Study of Atherosclerosis.

The researchers found that Black participants had a similar apnea hypopnea index to White participants (19.4 versus 18.7 events/hour), but higher wake SpO2 (96.1 versus. 95.7), current smoking (11.8 versus 5.9 percent), and body mass index (30.4 versus 27.9 kg/m2). Desaturation sensitivity was 0.31 standard deviations lower in Asian participants and 0.13 standard deviations lower in Black participants versus White participants in unadjusted analysis; however, in adjusted analyses, desaturation sensitivity was 0.27 standard deviations lower in Black versus White participants, with no differences seen for Asian or Hispanic participants. Similar results were observed when adjusting for baseline saturation or sex stratification.

“Our findings suggest that these measurement problems may lead to underestimation of the severity of OSA in Black individuals,” Azarbarzin said in a statement. “However, whether this underestimation of oxygen drops should lead to important differences in diagnosing and managing OSA in Black and other individuals with dark skin is unclear.”


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