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Cultural Diversity |

Sleep Architecture in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) in Adult African American Population and Relationship With Apnea Hypopnea Index (AHI) and Epworth Sleepiness Scale (ESS)

Rawshan Ali Basunia, MD; Samir Fahmy, MD; Marie Frances Schmidt, MD; Chidozie Agu, MD; Bikash Bhattarai, MD; Vikram Oke, MD; Danilo Enriquez, MD; Joseph Quist, MD
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Interfaith Medical Center, Jamaica, NY


Chest. 2015;148(4_MeetingAbstracts):354A. doi:10.1378/chest.2270969
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Abstract

SESSION TITLE: Race and Ethnicity in Lung Disease

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 26, 2015 at 04:30 PM - 05:30 PM

PURPOSE: Sleep architecture in adult African American population with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) was not defined previously.

METHODS: Patients who attended a sleep laboratory for diagnostic polysomnography (PSG) in one month in a hospital in Brooklyn, NY, where majority of patient population is African American were enlisted in the study. Subjects filled Epworth Sleepiness Scale (ESS) questionnaire before the PSG study. Inclusion criteria: Age ≥ 18 years; African American Race; Subjects attended for diagnostic PSG. Exclusion criteria: Subjects attended for Positive Airway Pressure (PAP) titration studies. PSGs were scored manually by a sleep technician. Data was analyzed using SPSS version 15. Mild, moderate and severe OSAHS were defined as AHI 5 to <15, 15 to 30 and > 30 respectively.

RESULTS: Thirty subjects met the selection criteria. Mean age was 53.40 ± 11.60 years. Male and female were 46.7% and 53.3% respectively. BMI ≥ 30 was present in 83.3% of subjects. Mild, moderate and severe OSAHS were present in 30.0%, 23.3% and 46.7% respectively. Sleep architecture comprised of N1 sleep 19.50 ± 19.00 % (Median ± I-Q range), N2 sleep 53.93 ± 13.39 % (Mean ± SD; 95% CI 48.40- 59.46 ), N3 sleep 3.90 ± 19.50 % (Median ± I-Q range) and REM sleep 8.92 ± 6.21 % (Mean ± SD; 95% CI 6.35- 11.48). Median ± I-Q range of total sleep time in minutes, sleep efficiency %, arousal index and awakening index were 334.00 ± 83.75, 84.00 ± 21.00, 15.50 ± 41.65 and 5.90 ± 4.95 respectively. AHI was 19.40 ± 65.60 (Median ± I-Q range) and ESS was 10.88 ± 6.11 (Mean ± SD; 95% CI 8.35 - 13.40). With Spearman’s correlation, AHI positively correlated with N1 sleep (P <0.01), arousal index (P <0.01) and awakening index (P <0.01) and negatively correlated with N2 sleep (P <0.05), N3 sleep (P <0.01), total sleep time (P <0.05), and sleep efficiency (P <0.05). ESS was negatively correlated with N3 sleep (P <0.05). No correlation was found between AHI and ESS.

CONCLUSIONS: In adult African Americans with Obstructive Sleep Apnea-Hypopnea Syndrome, N1 sleep, arousal and awakening increases, while N3 sleep, REM sleep, total sleep time and sleep efficiency decreases. Higher AHI correlates with more N1 sleep, arousal and awakenings and less N2, N3 sleep, total sleep time and sleep efficiency. There is no correlation between AHI and ESS.

CLINICAL IMPLICATIONS: Interpretation of sleep disturbances in African American population with Obstructive Sleep Apnea-Hypopnea Syndrome and targeting those abnormalities with therapeutic interventions.

DISCLOSURE: The following authors have nothing to disclose: Rawshan Ali Basunia, Samir Fahmy, Marie Frances Schmidt, Chidozie Agu, Bikash Bhattarai, Vikram Oke, Danilo Enriquez, Joseph Quist

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