Racial disparity in sleep apnea-related mortality in the United States

Lee, Yu-Che; Chang, Ko-Yun; Mador, M. Jeffery

doi:10.1016/j.sleep.2021.11.014

Cited by 10 publications

(8 citation statements)

References 54 publications

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“…Two large‐scale studies investigated mortality risk associated with OSA across ethnicities. Lee et al reviewed 20 years of data from the US National Center for Health Statistics, provided by the Centers for Disease Control and Prevention, reporting age‐adjusted OSA‐related mortality rates to be higher in men compared with women, and strikingly higher in Blacks compared to Whites (3.5 and 2.4 per 1,000,000 population, respectively)—see Figure 2 26 . Additionally, a significant uptrend in mortality in Black males was reported.…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 99%

Contemporary Concise Review 2022: Sleep

O'Driscoll

Young

2023

Respirology

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SUMMARY OF KEY POINTS COVID‐19 and sleep The COVID‐19 pandemic is associated with an increase in insomnia and impaired sleep quality Health care workers are particularly susceptible and improved with cognitive behavioural therapy for insomnia (CBT‐I) Long COVID has significant effects on sleep OSA impacts on the severity of acute COVID‐19 illness Obstructive sleep apnoea Large trials of clinically representative patients confirm the cardiovascular benefits of CPAP treatment in OSA CPAP may improve long‐term cognitive outcomes in OSA, but further research is needed Racial disparities in OSA prevalence and mortality risk are becoming evident Periodic evaluation of OSA risk in pregnancy is important as timing may be key for intervention to prevent or treat cardiovascular risk factors Insomnia Comorbid insomnia and obstructive sleep apnoea (COMISA) can frequently co‐exist and the combined negative effects of both may be deleterious, particularly to cardiovascular health There is evidence for effectiveness with novel orexin receptor antagonists

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Section: Obstructive Sleep Apnoeamentioning

confidence: 99%

Contemporary Concise Review 2022: Sleep

O'Driscoll

Young

2023

Respirology

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“…Obstructive sleep apnea (OSA) is a common condition that causes interrupted breathing during sleep [Punjabi, 2008;Young et al, 1993]. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep apnea-related mortality [Kalliny and McKenzie, 2017;Lee et al, 2021]. When used throughout the entirety of sleep, continuous positive airway pressure therapy (CPAP) eliminates nearly 100% of obstructive apneas for the majority of treated patients [Reeves-Hoche et al, 1994;Sawyer et al, 2011;Sullivan et al, 1981].…”

Section: Experimental Evaluationmentioning

confidence: 99%

Planning to Fairly Allocate: Probabilistic Fairness in the Restless Bandit Setting

Herlihy¹,

Prins²,

Srinivasan³

et al. 2021

Preprint

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Restless and collapsing bandits are commonly used to model constrained resource allocation in settings featuring arms with action-dependent transition probabilities, such as allocating health interventions among patients [Whittle, 1988;. However, state-of-the-art Whittleindex-based approaches to this planning problem either do not consider fairness among arms, or incentivize fairness without guaranteeing it [Mate et al., 2021]. Additionally, their optimality guarantees only apply when arms are indexable and threshold-optimal. We demonstrate that the incorporation of hard fairness constraints necessitates the coupling of arms, which undermines the tractability, and by extension, indexability of the problem. We then introduce PROBFAIR, a probabilistically fair stationary policy that maximizes total expected reward and satisfies the budget constraint, while ensuring a strictly positive lower bound on the probability of being pulled at each timestep. We evaluate our algorithm on a real-world application, where interventions support continuous positive airway pressure (CPAP) therapy adherence among obstructive sleep apnea (OSA) patients, as well as simulations on a broader class of synthetic transition matrices.

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“…Obstructive sleep apnea (OSA) is a chronic sleep disorder associated with multiple comorbidities (e.g., hypertension, obesity, diabetes mellitus, metabolic syndrome, and atherosclerotic cardiovascular diseases), poor quality of life, and premature death [ 1 , 2 , 3 , 4 , 5 ]. It is characterized by episodic narrowing of the upper airway during sleep [ 2 , 3 , 6 ] leading to complete or partial airway closure (apneas and hypopneas).…”

Section: Introductionmentioning

confidence: 99%

“…Overall, obstructive sleep apnea is highly underdiagnosed, especially in non-white populations, despite having significant health and mortality impacts. [ 4 , 5 , 8 , 9 ]. Indeed, up to 80% of individuals with OSA remain undiagnosed despite adequate access to health care [ 4 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The Case for Early Use of Glucagon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Patients with Comorbid Diabetes and Metabolic Syndrome

Sultana

Sissoho

Kaushik

et al. 2022

Life

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Patients with obstructive sleep apnea (OSA) have high rates of co-occurring type 2 diabetes, hypertension, obesity, stroke, congestive heart failure, and accelerated atherosclerotic cardiovascular diseases. These conditions frequently require multiple medications, raising the risk of polypharmacy, adverse drug–drug and drug–disease interactions, decreased quality of life, and increased healthcare cost in these patients. The current review of extant literature presents evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RA) as one pharmacologic intervention that provides a “one-stop shop” for OSA patients because of the multiple effects GLP-1RA has on comorbidities (e.g., hypertension, diabetes, obesity, metabolic syndrome, and atherosclerotic cardiovascular diseases) that commonly co-occur with OSA. Examples of glucagon-like peptide-1 receptor agonists approved by the FDA for diabetes (some of which are also approved for obesity) are liraglutide, exenatide, lixisenatide, dulaglutide, semaglutide, and albiglutide. Prescribing of GLP-1RAs to address these multiple co-occurring conditions has enormous potential to reduce polypharmacy, cost, and adverse drug events, and to improve quality of life for patients living with OSA and diabetes. We thus strongly advocate for increased and early use of GLP-1RA in OSA patients with co-occurring diabetes and other cardiometabolic conditions common in OSA.

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Racial disparity in sleep apnea-related mortality in the United States

Cited by 10 publications

References 54 publications

Contemporary Concise Review 2022: Sleep

Contemporary Concise Review 2022: Sleep

Planning to Fairly Allocate: Probabilistic Fairness in the Restless Bandit Setting

The Case for Early Use of Glucagon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Patients with Comorbid Diabetes and Metabolic Syndrome

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