PURPOSE: Ethnic as well as gender differences have been reported in symptoms of obstructive sleep apnea (OSA). These differences have not been well-characterized amongst Hispanics. The purpose of our study was to evaluate the two common symptoms of excessive daytime sleepiness (EDS) as assessed by the Epworth sleepiness score (ESS) as well as that of witnessed apneas between Hispanic and Caucasians in a large cohort of patients with OSA.
METHODS: This was a retrospective study of patient charts from our sleep center. All patients who underwent full polysomnography (PSG), with a diagnosis of OSA, as defined by a threshold value of AHI > 5, were included in the study. Multiple PSG parameters as well as responses to our standard sleep questionnaire were recorded and tabulated. Incomplete questionnaires were excluded.
RESULTS: A total of 611 patients - 302 Hispanics and 309 Caucasians, were included in the final analysis. For demographic information refer to table 1 - Hispanic patients were more obese, and younger, with a higher proportion of women. Overall severity of sleep apnea as assessed by both AHI as well as O2 nadir was similar between both groups. As a group mean ESS was higher in Hispanics. Proportion of abnormal ESS (>10) as well as pathologic ESS (>18) was also higher amongst Hispanics. History of witnessed apneas was obtained in over 50% of the patients and there was no difference between ethnicities.
CONCLUSION: For the same degree of OSA severity Hispanic patients tended to demonstrate more severe EDS. No differences in other symptoms of OSA were seen.
CLINICAL IMPLICATIONS: The same degree of OSA seems to render Hispanics more susceptible to EDS. This may be a result of greater sleep fragmentation from OSA or a greater effect of sleep fragmentation, or could represent a greater tendency to self-report sleepiness, that may involve socio-cultural factors. An appreciation of these differences can help clinicians in screening different patient populations for OSA.
DISCLOSURE: Shyam Subramanian, None.