Year: 2025
Type: conference-abstract
Abstract: Introduction Diagnosis of obstructive sleep apnea (OSA) depends on the Apnea-Hypopnea Index (AHI), a metric with acknowledged limitations, but known variation across demographic groups. Novel methodologies may better quantify OSA pathophysiology, but differences in these metrics across age, sex, and race/ethnicity remain yet to be explored. Leveraging data from the Sleep Heart Health Study (SHHS) and the Multi-Ethnic Study of Atherosclerosis (MESA), we investigated potential variations in the emerging physiological metrics of OSA across participant demographics. Methods High-quality signals of participants from SHHS (n=5407) and MESA (n=1544) were analyzed for four physiological metrics: 1) Hypoxic Burden (area under oxygen desaturation ≥ 3% dips), 2) Ventilatory Burden (proportion of breaths with < 50% normalized amplitude), Autonomic Burden (increase in heart rate by ≥ 3 beats/min, independent of respiratory events), and Arousal Burden measured by ∆SWAK (change in delta power across K-complexes in N2 sleep). We only assessed participants with Ventilatory Burden > 25% to examine only those exhibiting some degree of abnormal overnight breathing. Each metric was regressed against age, sex, and race/ethnicity in separate univariate analyses. Multivariate analyses were adjusted for AHI3A or AHI4. A significance level of 0.05 was used and statistical analyses were done with RStudio v.4.4.2. Results Within the study population, participants were predominantly female (n=3635/6951, 52.3%), with a mean age of 64.4 ± 11.0 years. Most participants were self-reported as White (n=5143/6951, 74.0%). Sex differences were observed across all the physiological domains with males showing significantly higher Hypoxic, Ventilatory, Autonomic, and Arousal Burdens (p< 0.05). All physiological burden values increased with age, with the highest severity observed in the ≥80 years age group. Differences were also found significant among the race/ethnicity groups (p< 0.05). After adjusting for AHI3A and AHI4 separately, there was no change in the findings or significance of the analyses. Conclusion There were significant differences in OSA-related physiological burdens with variations across age, sex, and race/ethnicity, independent of AHI severity. These findings appear to be in addition to known differences in OSA severity and may offer insight into varying pathophysiologies across demographic groups. Support (if any)
Source: SLEEP
Institution: Icahn School of Medicine at Mount Sinai
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410502727