Sleep-disordered Breathing in Hispanic/Latino Individuals of Diverse Backgrounds. The Hispanic Community Health Study/Study of Latinos

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. had full access to the study data and take responsibility for the integrity of the data and accuracy of analyses.Correspondence and requests for reprints should be addressed to Susan Redline, M.D., M. 11,12). Baseline data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analyzed to estimate the prevalence of SDB and SDB symptoms, to describe associations with risk factors and diabetes and hypertension, and to explore variation in SDB by sex and Hispanic/Latino background. We hypothesized that SDB would be more prevalent in Hispanic/Latino groups with higher rates of obesity, and associated with an increased prevalence of hypertension and diabetes. Some of the results of these studies have been previously reported in the form of abstracts (13-15). MethodsThe online supplement provides detailed methods and additional results. SampleThe HCHS/SOL is a community-based cohort study of 16,415 self-identified Hispanic/Latino persons 18-74 years old recruited from randomly selected households in four U.S. field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). The multistage sampling design and cohort selection procedures have been described (16,17). Briefly, participants were recruited between 2008 and 2011 from defined geographic areas selecte...

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