Sleep Disorders in Aboriginal and Torres Strait Islander People and Residents of Regional and Remote Australia

Woods, Cindy; McPherson, Karen; Tikoft, Erik; Usher, Kim; Hosseini, Fariborz; Ferns, Janine; Jersmann, Hubertus; Antić, R; Maguire, Graeme

doi:10.5664/jcsm.5182

Cited by 22 publications

(27 citation statements)

References 17 publications

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“…A retrospective analysis of diagnostic sleep test data from the Northern Territory found that severe sleep apnoea was associated with male gender, increasing age, higher body weight, and Indigenous status [ 53 ]. Similar data from Central Australia and far north Queensland reported that compared with non-Indigenous people, Indigenous people diagnosed with OSA were more likely to be female, live in remote communities and be obese [ 54 ]. This is an area for further research given the prevalence of obesity in Indigenous communities and the associated risk of OSA with adverse health outcomes and increased all-cause mortality [ 53 ].…”

Section: Limitationsmentioning

confidence: 93%

Is sleep duration associated with overweight/obesity in Indigenous Australian adults?

2020

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Background: Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults. Methods: Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011-2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up; BMI was derived from measurement and categorised into normal weight (BMI = 18.5-24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group. Results: Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ 2 = 21.81, p < 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of > 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept < 7 h (OR = 1.77, 95% CI 0.38-3.94) and < 6 h (OR = 1.55, 95%CI = 0.58-4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept < 6 h (OR = 1.67, 95%CI 1.25-2.25). The risk of overweight/obesity diminished for both groups with sleep > 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally. Conclusion: Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.

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Section: Limitationsmentioning

confidence: 93%

Is sleep duration associated with overweight/obesity in Indigenous Australian adults?

2020

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“…23 Furthermore, OSA is also being increasingly recognized in the Indigenous/Aboriginal population and studies have demonstrated that Indigenous/Aboriginal patients have a higher chance of having OSA compared to non-Indigenous/Aboriginals. [24][25][26][27] A recent study from our center had demonstrated that a higher proportion of ATSI patients were noted to have severe OSA. 28 Although there is growing evidence to suggest that OSA manifests differently in different ethnic populations and has gender differences; however, there is limited evidence in the literature with regards to the ethnic and gender influence among Australian or other Indigenous/Aboriginal populations.…”

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

<p>Gender Differences in the Clinical and Polysomnographic Characteristics Among Australian Aboriginal Patients with Obstructive Sleep Apnea</p>

Mehra

Ghimire

Mingi

et al. 2020

NSS

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Background: In this study, we assessed the clinical and polysomnographic (PSG) characteristics according to gender among Australian Aboriginal men and woman diagnosed to have obstructive sleep apnea (OSA). Methods: In this retrospective study, all adult Aboriginal patients over 18 years of age diagnosed to have OSA with an apnea hypopnea index (AHI) > 5/hour over a 5 year period were included. Results: Of the 337 patients (168 females and 169 males), who underwent a diagnostic PSG, 297 (88%) were diagnosed to have OSA (AHI) >5/hour), 154/297 males (52%) and 143/297 females (48%). Amongst male and female patients with OSA, 63% and 37% were in the severe spectrum (AHI>30/hour). The male cohort had higher stage N1 NREM sleep (P<0.001), reduced N3 NREM sleep (P<0.001), higher AHI severity (P<0.001), higher NREM AHI (P<0.001), and high arousal index (P<0.005). REM sleep-related AHI was higher among female patients with all severity of OSA, along with severe oxygen desaturation during REM sleep. Among patients with severe OSA, the female cohort were younger (age 46 years vs 49 years, P=0.030) and had higher BMI with all severity of OSA, while males had larger neck circumference compared to females. Hypertension increased the odds of severe OSA versus the combined odds of mild and moderate OSA for both genders. Conclusion: This study highlights some important differences in the way sleep apnea manifests in Australian Aboriginal males and females and further studies are warranted to explore avenues to look for a physiological basis for these observations and targeted interventions.

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“…2,3 Increasing accessibility to diagnostic and treatment modalities, such as continuous positive airway pressure (CPAP) therapy for people living in regional and remote areas, more so in people with low socioeconomic status has led to more patients being diagnosed and treated with CPAP therapy. [4][5][6] In the Northern Territory of Australia, the demographic profile is spread over a vast geographical area, with 81% of the indigenous population living in remote or very remote areas. 7 The northern part of Australia is also noted to have tropical weather conditions, and humidity is also high most of the year around ( Figure 1A).…”

Section: Introductionmentioning

confidence: 99%

A Cost-Effective Novel Innovative Box (C-Box) to Prevent Cockroach Infestation of Continuous Positive Airway Pressure Equipment: A Unique Problem in Northern Tropical Australia

Heraganahally

White²

2019

The American Journal of Tropical Medicine and Hygiene

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Sleep Disorders in Aboriginal and Torres Strait Islander People and Residents of Regional and Remote Australia

Cited by 22 publications

References 17 publications

Is sleep duration associated with overweight/obesity in Indigenous Australian adults?

Is sleep duration associated with overweight/obesity in Indigenous Australian adults?

<p>Gender Differences in the Clinical and Polysomnographic Characteristics Among Australian Aboriginal Patients with Obstructive Sleep Apnea</p>

A Cost-Effective Novel Innovative Box (C-Box) to Prevent Cockroach Infestation of Continuous Positive Airway Pressure Equipment: A Unique Problem in Northern Tropical Australia

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