Boston, MA (September 5, 2018) - Sleep apnea is a common sleep disorder that is associated with an increased prevalence of cardiovascular disease, hypertension, diabetes and other chronic health disorders. About 80 to 90 percent of individuals with sleep apnea are undiagnosed and a large number of them are African-Americans.
A new study by investigators at Brigham and Women's Hospital determined the prevalence of sleep apnea among 852 African-American men and women living in Jackson, Miss., and participating in the Jackson Heart Sleep Study. Researchers explored sleep apnea predictors and estimated the proportion of undiagnosed cases. They found a high prevalence of sleep apnea among this large sample of African-American men and women, and the majority - 95 percent - were undiagnosed and untreated. Results are published on Sept. 5 in the journal SLEEP.
"We discovered that only 5 percent of individuals with moderate or severe sleep apnea had been diagnosed. In other words, over 95 percent of this sample experience nightly stresses associated with periods when breathing stops and oxygen levels fall. Untreated sleep apnea can increase risk for hypertension-related diseases such as stroke, a condition disproportionately common in African-Americans," said Dayna A. Johnson, Ph.D, associate epidemiologist in the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital and lead author of the study. "We also learned that asking about habitual snoring and measuring neck size (a risk factor for sleep apnea) can help identify individuals at risk."
Researchers found that among 852 adults in the study, 24 percent had moderate or severe sleep apnea, but only 5 percent had been diagnosed by a doctor. Men had a 12-15 percent higher prevalence of the disorder compared to women. Habitual snoring, higher body mass index and larger neck size were important markers of sleep apnea. The average age of the study sample was 63 years old - 66 percent of participants were female and 53.8 percent college-educated. This is the first-known study of its size to conduct objective testing for sleep apnea and administer validated questionnaires in a sample of African-Americans.
"There is a large burden of untreated sleep apnea in the population. Our results point to the opportunity to improve sleep apnea screening and diagnosis in the population as a means for reducing health disparities," said Susan Redline, MD, MPH, senior physician in the Division of Sleep and Circadian Disorders at BWH and senior author of the study.
"These findings in the Jackson Heart Study reveal that sleep apnea is underdiagnosed and a potential threat to the health and safety of African-Americans," said Michael Twery, Ph.D., director of the National Center on Sleep Disorders Research at NHLBI, part of the National Institutes of Health. "Further studies are needed to develop the tools and systems required to facilitate diagnosis and treatment of sleep apnea in African-Americans and other communities."
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Research reported in this publication was supported by the National Heart, Lung, and Blood Institute, (NHLBI) R01HL110068, 3R01HL110068-03S2, T32HL007901-18 and K01HL138211; the National Institute of General Medical Sciences, U54GM115428; 5R35HL135818. This work was also conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centers. The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201300049C and HHSN268201300050C), Tougaloo College (HHSN268201300048C), and the University of Mississippi Medical Center (HHSN268201300046C and HHSN268201300047C) contracts from the NHLBI and the National Institute for Minority Health and Health Disparities (NIMHD).
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.
Journal
SLEEP