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Abstract
Background
Pacific islanders (PI) have a high prevalence of severe OSA, attributed to obesity. Ethnic differences in mechanisms contributing to OSA have been reported. We compared physiological polysomnography characteristics in obese PI and Caucasian (C) patients with OSA.
Methods
Retrospective polysomnography (PSG) studies from a tertiary hospital sleep laboratory were identified for PI and age, gender and BMI matched C patients (BMI>30 kgm²). All PSGs were rescored by a single scorer, and pharyngeal collapsibility (Vpassive), upper airway muscle compensation (Vcomp), arousal threshold (AT), [all expressed as percentage of steady-state breathing (Veupnea)], and loop gain (LG) were determined non-invasively via established/validated techniques.
Progress to date
14 PI [8 female] and 29 C [15 female] were identified. There were no differences in age [52.2±17.0 PI; 52.5±13.3 C years], BMI [46.9±7.7 PI; 48.2±10.1 C kgm²] or AHI (35.6 [17.9–77.5] PI; 41.2 [20.9–83.6] C events/hour) (mean±SD or median[IQR]; all p>0.4; paired t-test or Wilcoxon signed rank). There were no significant differences in Vpassive (88.8 [88.4–97.1] PI; 91.8 [44.4–95.8]C %Veupnea; p=0.38), Vcomp (1.2 [-12.0–9.2] PI; 5.8 [-1.9–9.6] C %Veupnea; p=0.30), AT (131.4 [110.5–140.8] PI; 126.1 [110.4–180.7] C %Veupnea; p=0.67) or LG (0.6±0.1 PI; 0.7±0.3 C; p=0.23).
Intended outcome and impact
In a small cohort of PI and age, gender and BMI matched C with OSA, upper airway obstructive event frequency was the same and there were no differences in physiological phenotypes, suggesting similar mechanisms contribute to OSA severity in both groups. Confirmation of these findings in a larger cohort is ongoing.
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Details
1 Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, Australia; Westmead Sleep Investigation and Research Centre, Sydney, Australia
2 Sleep and Circadian Medicine Laboratory, Department of Physiology, Monash University, Melbourne, Australia; School of Psychological Sciences, Monash University, Melbourne, Australia; Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
3 Department of Respiratory and Sleep Medicine, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
4 Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, Australia; Westmead Sleep Investigation and Research Centre, Sydney, Australia; Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, Australia; University of Sydney at Westmead Hospital, Westmead, Australia