0607 Clinical Phenotypes of OSA in Diverse Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A232-A232
Author(s):  
K T Gonzalez ◽  
W Tarraf ◽  
D M Wallace ◽  
A Stickel ◽  
N Schneiderman ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Community Health ◽  
Latent Class ◽  
Health Resources ◽  
Health Study ◽  
Clinical Samples ◽  
Apnea Hypopnea Index ◽  
Fit Statistics ◽  
Hispanic Community ◽  
Obstructive Sleep

Abstract Introduction Recent work on US non-Latino Whites and Europeans from clinical samples used obstructive sleep apnea (OSA) symptoms to generate OSA phenotypes for individuals with moderate-severe OSA and proposed between 3-5 clusters. Validating these clusters in a diverse Hispanic/Latino community-based population with different biopsychosocial characteristics is crucial for early OSA identification and more personalized treatment. Methods This work is based on baseline data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/SOL is a prospective cohort study designed using a multisite (Bronx, NY, Chicago, IL, Miami, FL, San Diego, CA) multistage probability sample. The subpopulation of interest included adults 18-74 years (unweighted n=1,623) meeting criteria for moderate-severe OSA symptoms (≥15 Apnea-Hypopnea index (AHI) events per hour). We performed latent class analysis (LCA) using 15 common OSA symptoms to identify phenotype clusters. Results Average age was 52.4 ± 13.9 years and 34.1% were female. Mean AHI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided best fit to the data. The symptom profiles were consistent with (1) a Minimally Symptomatic group (46.8%), (2) a Disturbed Sleep group (38.1%), and (3) a Daytime Sleepiness group (15.1%). Validation analyses using alternative hierarchical and partitioning algorithms also suggested support for a three-class solution. Conclusion Sleep apnea phenotypes among diverse Hispanics/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium. However, we found notable differences in the prevalence of these clusters relative to Whites. This suggests that other biopsychosocial factors may be contributing to OSA phenotypes among Hispanics/Latinos. Identification of OSA phenotypes in Hispanics/Latinos could inform better sleep interventions and therapeutics and help better align public health resources. Support 5R01AG048642-05; R21AG056952; R21HL140437.

Phenotypes of Obstructive Sleep Apnea in the Hispanic Community Health Study/Study of Latinos

SLEEP ◽  
2021 ◽  
Author(s):  
Kevin A Gonzalez ◽  
Wassim Tarraf ◽  
Douglas M Wallace ◽  
Ariana M Stickel ◽  
Neil Schneiderman ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Community Health ◽  
Latent Class ◽  
Health Study ◽  
Clinical Samples ◽  
Hispanic Community ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Hispanic Latinos

Abstract Study Objectives Recent work on US Whites from clinical samples used obstructive sleep apnea (OSA) symptoms to generate phenotypes for individuals with moderate-severe OSA which suggested 3 to 5 symptom classes. However, it is unknown whether similar classes generalize to diverse Hispanics/Latino adults. Therefore, we sought to fill this gap by empirically deriving sleep phenotypes among a large sample of diverse Hispanics/Latinos. Methods We used data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011), a prospective cohort study designed using a multisite multistage probability sample of adults 18-74 years old. The subpopulation of interest included participants with moderate-severe OSA symptoms (≥15 respiratory event index (REI) events per hour; n=1,605). We performed latent class analysis for complex survey data using 15 common OSA symptoms (e.g. Epworth Sleepiness Scale) and four comorbidities to identify phenotype classes. Results Average age was 52.4 ± 13.9 years and 34.0% were female. Mean respiratory event index was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided best fit to the data. The three phenotypes were: 1) Minimally Symptomatic (47.7%), 2) Excessive sleepiness (37.1%), and (3) Disturbed Sleep (15.2%). Sensitivity models were consistent with main proposed solution. Conclusions Derived sleep phenotypes among diverse Hispanic/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium, but we found notable differences in class prevalence relative to Whites. Further research is needed to link derived sleep phenotypes to health comorbidities in diverse populations.

scholarly journals Association of self-reported physical activity with obstructive sleep apnea: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

2016 ◽  
Vol 93 ◽  
pp. 183-188 ◽  
Author(s):  
Rosenda Murillo ◽  
Kathryn J. Reid ◽  
Elva M. Arredondo ◽  
Jianwen Cai ◽  
Marc D. Gellman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Community Health ◽  
Health Study ◽  
Hispanic Community ◽  
Obstructive Sleep

scholarly journals Empirically Derived Dietary Patterns Using Robust Profile Clustering in the Hispanic Community Health Study/Study of Latinos

2020 ◽  
Vol 150 (10) ◽  
pp. 2825-2834
Author(s):  
Briana J K Stephenson ◽  
Daniela Sotres-Alvarez ◽  
Anna-Maria Siega-Riz ◽  
Yasmin Mossavar-Rahmani ◽  
Martha L Daviglus ◽  
...  
Keyword(s):  
United States ◽  
Community Health ◽  
Dietary Patterns ◽  
Latent Class ◽  
The United States ◽  
Ethnic Background ◽  
Latent Class Models ◽  
Nutrition Intervention ◽  
Health Study ◽  
Hispanic Community

ABSTRACT Background Latent class models (LCMs) have been used in exploring dietary behaviors over a wide set of foods and beverages in a given population, but are prone to overgeneralize these habits in the presence of variation by subpopulations. Objectives This study aimed to highlight unique dietary consumption differences by both study site and ethnic background of Hispanic/Latino populations in the United States, that otherwise might be missed in a traditional LCM of the overall population. This was achieved using a new model-based clustering method, referred to as robust profile clustering (RPC). Methods A total of 11,320 individuals aged 18–74 y from the Hispanic Community Health Study/Study of Latinos (2008–2011) with complete diet data were classified into 9 subpopulations, defined by study site (Bronx, Chicago, Miami, San Diego) and ethnic background. At baseline, dietary intake was ascertained using a food propensity questionnaire. Dietary patterns were derived from 132 food groups using the RPC method to identify patterns of the general Hispanic/Latino population and those specific to an identified subpopulation. Dietary patterns derived from the RPC were compared to those identified from an LCM. Results The LCM identified 48 shared consumption behaviors of foods and beverages across the entire cohort, whereas significant consumption differences in subpopulations were identified in the RPC model for these same foods. Several foods were common within study site (e.g., chicken, orange juice, milk), ethnic background (e.g., papayas, plantain, coffee), or both (e.g., rice, tomatoes, seafood). Post hoc testing revealed an improved model fit in the RPC model [Deviance Information Criterion DICRPC = 2.3 × 104, DICLCM  = 9.5 × 106]. Conclusions Dietary pattern behaviors of Hispanics/Latinos in the United States tend to align by ethnic background for some foods and by location for other foods. Consideration of both factors is imperative to better understand their contributions to population health and developing targeted nutrition intervention studies.

scholarly journals Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos

2016 ◽  
Vol 12 (05) ◽  
pp. 719-726 ◽  
Author(s):  
Amit Chopra ◽  
Molly Jung ◽  
Robert C. Kaplan ◽  
David W. Appel ◽  
Elizabeth A. Dinces ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Community Health ◽  
Hearing Impairment ◽  
Health Study ◽  
Hispanic Community

scholarly journals 0722 The Association Between Obstructive Sleep Apnea and Neurobehavioural Function in Men: A Large, Population-Based Cohort Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A274-A275
Author(s):  
J L Parker ◽  
R J Adams ◽  
S L Appleton ◽  
Y A Melaku ◽  
A Vakulin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Inspection Time ◽  
Sleep Disruption ◽  
Clinical Samples ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is linked with impaired vigilance, attention, memory and executive function. However, this evidence largely comes from small experimental studies or larger studies in clinical samples and therefore the scope and magnitude of OSA driven neurobehavioural dysfunction in the general population remains unclear. This study aimed to examine the cross-sectional association between OSA and neurobehavioural function in a large community sample of men. Methods A total of 837 participants from the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a longitudinal cohort of men 40+ years, underwent full overnight polysomnography. Participants completed the inspection time (IT) test, mini-mental state examination (MMSE), Fuld object memory evaluation (FOME), and trail-making test (TMT) part A (TMT-A) and part B (TMT-B). Using regression models adjusted for multiple important covariates, we examined the association between neurobehavioural function scores, clinical metrics of OSA severity (Apnea-Hypopnea Index (AHI); percentage total sleep time with oxygen saturation <90% (TST90), and measures of sleep disruption (duration of rapid eye movement (REM) and non-REM (NREM) sleep; and total sleep time (TST). Results In multivariable linear regressions, greater TST was associated with worse IT scores (B=13.688, 95% CI [0.134, 27.241], P=0.048) and TMT-B scores (B=19.255, 95% CI [0.931, 37.578], P=0.040). In logistic regressions, greater TST was associated with better MMSE scores (Odds ratio [OR]=0.440, 95% CI [0.194, 0.997], P=0.049); and higher AHI was strongly associated with worse FOME scores in fully adjusted models (OR=1.358, 95% CI [1.252, 1.472], P<0.001). Conclusion The AHI and TST were positively, significantly associated with neurobehavioural function across different domains. This cross-sectional data shows that neurobehavioural function deficits in OSA are directly related to sleep and breathing disruptions. Future large prospective studies are needed to determine if OSA and sleep disruption predict future onset of neurobehavioural dysfunction and cognitive decline. Support National Health and Medical Research Council and the Adelaide Institute for Sleep Health.

Abstract 17143: Obstructive and Central Sleep Apnea and Risk of Incident Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Patricia Tung ◽  
Yamini S Levitzky ◽  
Rui Wang ◽  
Stuart F Quan ◽  
Daniel J Gottlieb ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Community Based ◽  
Obstructive Sleep ◽  
History Of

INTRODUCTION: Prior studies have documented a higher prevalence of atrial fibrillation (AF) in those with obstructive sleep apnea (OSA). OSA has been associated with AF recurrence following cardioversion and ablation, and with prevalent and incident AF in cross-sectional and retrospective studies. Central sleep apnea (CSA) also has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have evaluated the association of CSA with AF in population studies. METHODS: We assessed the association of OSA and CSA with incident AF among 3,420 subjects without a history of AF in the Sleep Heart Health Study (SHHS), a prospective, community-based study designed to evaluate the cardiovascular consequences of sleep disordered breathing. Subjects underwent overnight polysomnography at baseline and were followed over time for the development of incident AF, documented at any time after baseline polysomnogram until the end of follow-up. OSA was defined as an obstructive apnea-hypopnea index ≥ 5 and CSA was defined as a central apnea index ≥ 5. RESULTS: At baseline, the sample include 1499 men (44.4%) with a mean age of 62.4 (±10.9); 1569 (45.9%) subjects met criteria for mild to severe OSA and 54 (1.6%) for CSA. Over a mean follow-up of 8.2 years, 382 cases of incident AF were identified. The prevalence of both OSA and CSA was higher among those who developed AF compared to those who did not (OSA 49% vs 44%, p=0.001 and CSA 5% vs 1.2%, p=0.001). After adjustment for multiple AF risk factors, CSA was associated with an approximately 2-fold increased odds of incident AF (RR=2.38, 95% CI, 1.15-4.94; p = 0.02). The association persisted after exclusion of 258 subjects with a history of heart failure (RR=2.78, 95% CI, 1.28-6.04; p = 0.01). We did not find a significant association of OSA with incident AF (Table). CONCLUSION: In our prospective, community-based cohort baseline CSA was associated with incident AF.

scholarly journals 0609 Sleep Phenotypes in Middle-Aged and Older Hispanics/Latinos. Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A233-A233
Author(s):  
B Wu ◽  
W Tarraf ◽  
D M Wallace ◽  
A Stickel ◽  
N Schneiderman ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Duration ◽  
Latent Class ◽  
Rating Scale ◽  
Community Dwelling ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Middle Aged ◽  
Targeted Interventions ◽  
Percent Time

Abstract Introduction Identifying sleep phenotypes in the diverse and understudied US Hispanic/Latino population is critical to developing interventions and mitigating distal clinical outcomes (e.g. dementias). Methods Using latent class analyses (LCA), we identify empirically derived and clinically meaningful sleep phenotypes using data on community dwelling middle-aged/older adults (ages ≥45-years) from the HCHS/SOL (2008-2011) - Investigation of Neurocognitive Aging (n=6,377). Sleep variables used included Apnea/Hypopnea Index (AHI), percent time SpO2<90%, Epworth Sleepiness Scale (ESS), Women’s Health Initiative Insomnia Rating Scale (WHIIRS), self-reported average sleep duration, restless legs symptoms, napping frequency, and sleep quality. Results Mean (M) age was 56.4±8.1 years, and 54.7% were female. Average AHI, ESS, WHIIRS, and sleep duration were 8.7±13.1, 6.0±5.0, 7.6±5.5, and 7.8±1.4, respectively, and 25.8% had zero percent time SpO2 <90%. Fit statistics indicated that a four-class solution provided the best data fit. The derived classes, adjusting for age, sex, income, and acculturation, corresponded with four clinically meaningful groups: (1) 28.8% were asymptomatic [(M) AHI=0.8; (M) ESS=5.6; (M)WHIIRS=7.6; (M) sleep duration=7.8; 0% SpO2<90%=74.1%], (2) 25.7 % were asymptomatic mild sleep apnea [(M) AHI=6.2; (M) ESS=3.8; (M) WHIIRS=2.9; (M) sleep duration=7.8; 0% SpO2<90%=8.8%], (3) 19.4% were symptomatic sleep apnea [(M) AHI=25.6; (M) ESS=8.5; (M) WHIIRS=7.2; (M) sleep duration=7.7; 0% SpO2<90%= 0.5%], and (4) 26.1% were insomnia [(M) AHI=5.7; (M) ESS=6.7; (M) WHIIRS=13.0; (M) sleep duration=7.8; 0% SpO2<90%=10.3%]. Classification into groups 3 and 4 were primarily driven by elevated AHI and WHIIRS scores, respectively. The distribution of scores in the derived groups suggest variations relative to current clinical thresholds. Conclusion We identified 4-groups using LCA in a community-based sample of diverse U.S. Hispanic/Latino adults. Better characterization of sleep phenotypes for Hispanics/Latinos can help in developing targeted interventions studies and ameliorate health disparities. Support 5R01AG048642-05; R21AG056952; R21HL140437.

472-P: Associations between Ankle Brachial Index, Diabetes, and Sleep Apnea: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Database

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 472-P
Author(s):  
MOHAMMED M. ALSHEHRI ◽  
ABDULFATTAH S. ALQAHTANI ◽  
AQEEL M. ALENAZI ◽  
SHAIMA ALOTHMAN ◽  
MONIRA ALDHAHI ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Community Health ◽  
Ankle Brachial Index ◽  
Health Study ◽  
Hispanic Community

Abstract P186: Obstructive Sleep Apnea and Risk of Chronic Kidney Disease in the ARIC Sleep Heart Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Kelsie M Full ◽  
Chandra Jackson ◽  
Casey M Rebholz ◽  
Kunihiro Matsushita ◽  
Pamela L Lutsey
Keyword(s):  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kidney Disease ◽  
Health Behaviors ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Heart Health ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder and may be associated with the development of chronic kidney disease (CKD) through hypoxia, inflammation, and oxidative stress. However, the prospective relationship between OSA and incident CKD remains unknown. In this study, we leveraged in-home polysomnography (PSG) data from a large community-based cohort of adults to examine the association between OSA and risk of incident CKD in late-midlife. Methods: Participants in the Atherosclerosis Risk in Communities (ARIC) study (N=1,525; mean age=62.5 ± 5.4 years, 52.4% female) completed in-home PSG assessments as part of the Sleep Heart Health Study. OSA severity was defined according to apnea-hypopnea index (AHI) (events/hour): normal <5.0, mild 5.0-14.9, moderate 15.0-29.9, and severe ≥30.0. Incident CKD was defined according to estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and at least 25% decline in eGFR from baseline, CKD-related hospitalization or death, or end-stage renal disease. Cox proportional hazards regression was used to estimate OSA severity with risk of incident CKD. Models were adjusted for demographics, health behaviors, BMI, and other markers of cardiometabolic conditions. Results: Among 1,525 participants, a total of 461 CKD events occurred over an average of 19 years of follow-up. After adjustment for demographics and health behaviors, severe OSA (AHI ≥30.0) was associated with increased risk of CKD (Hazard Ratio (HR): 1.51; 95% Confidence Interval (CI): 1.08, 2.10). This association was attenuated after additional adjustment for BMI (HR; 1.07, CI: 0.75, 1.52). Conclusions: Overall, OSA was linked to greater CKD risk. The association was attenuated after adjusting for obesity, a risk factor for both conditions. Due the high prevalence of OSA and CKD in the US adult population, more investigation is needed. Figure 1. Estimated probability of years free of Chronic Kidney Disease (CKD) by obstructive sleep apnea (OSA) severity in the ARIC Sleep Heart Health Study:

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