Sleep-disordered breathing in Hispanic/Latino individuals of diverse backgrounds. The Hispanic Community Health Study/Study of Latinos

Am J Respir Crit Care Med. 2014 Feb 1;189(3):335-44. doi: 10.1164/rccm.201309-1735OC.

Abstract

Rationale: Hispanic/Latino populations have a high prevalence of cardiovascular risk factors and may be at risk for sleep-disordered breathing (SDB). An understanding of SDB among these populations is needed given evidence that SDB increases cardiovascular risk.

Objectives: To quantify SDB prevalence in the U.S. Hispanic/Latino population and its association with symptoms, risk factors, diabetes, and hypertension; and to explore variation by sex and Hispanic/Latino background.

Methods: Cross-sectional analysis from the baseline examination of the Hispanic Community Health Study/Study of Latinos.

Measurements and main results: The apnea-hypopnea index (AHI) was derived from standardized sleep tests; diabetes and hypertension were based on measurement and history. The sample of 14,440 individuals had an age-adjusted prevalence of minimal SDB (AHI ≥ 5), moderate SDB (AHI ≥ 15), and severe SDB (AHI ≥ 30) of 25.8, 9.8, and 3.9%, respectively. Only 1.3% of participants reported a sleep apnea diagnosis. Moderate SDB was associated with being male (adjusted odds ratio, 2.7; 95% confidence interval, 2.3-3.1), obese (16.8; 11.6-24.4), and older. SDB was associated with an increased adjusted odds of impaired glucose tolerance (1.7; 1.3-2.1), diabetes (2.3; 1.8-2.9), and hypertension. The association with hypertension varied across background groups with the strongest associations among individuals of Puerto Rican and Central American background.

Conclusions: SDB is prevalent in U.S. Latinos but rarely associated with a clinical diagnosis. Associations with diabetes and hypertension suggest a large burden of disease may be attributed to untreated SDB, supporting the development and evaluation of culturally relevant detection and treatment approaches.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / etiology
  • Female
  • Health Status Disparities
  • Health Surveys
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Hypertension / ethnology
  • Hypertension / etiology
  • Logistic Models
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / ethnology
  • Polysomnography
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / ethnology*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult