Abstract
Introduction
Sleep-disordered breathing in Native Hawaiians and Pacific Islanders (NHPIs), its relationship to type 2 diabetes mellitus (DM), chronic renal, and heart disease, is not well known. NHPIs comprise only 1.3% of Utah’s population, but have the highest rates of DM and deaths due to diabetic kidney disease in Utah. This study assessed the nature of sleep-disordered breathing, its association with demographic variables, and comorbidities, and adherence patterns to positive airway pressure (PAP) therapy.
Methods
University of Utah sleep clinics patient databases from 2014 were evaluated to identify NHPIs using first/last names. Electronic medical records were reviewed to confirm patient ethnic origin, demographic data, and comorbidities. The most recent PAP downloads were obtained.
Results
Of 106 NHPIs were identified, data available for 104 patients (71 males, 33 females) was analyzed. Mean age of males was 47 + 13 years and females 48±13 years. Prevalence rates of obesity were 13% (female 9%, male 15%) with BMI≥30, 33% (female 24%, male 23%) with BMI≥35, and 49% (female 58%, Male 23%) with BMI≥40). Majority of patients had severe OSA (61% males with AHI≥30; 39% females with ≥ 30), with overall mean AHI of 47±38. A high prevalence of comorbidities was noted: 61% hypertension (male 58%; female 67%), diabetes 54% (male 48%, female 67%), renal disease 20% (male 21%, female 18%), coronary artery disease 13% (male 14%, female 9%), and congestive heart failure 13% (male 15%, female 9%). Prevalence of lung disease was low 13% (male 9%, female 18%).
Conclusion
NHPIs evaluated for sleep-disordered breathing have high rates of obesity, severe OSA, and concerning comorbidities. PAP adherence in this group was poor compared to overall adherence for patients seen in University of Utah sleep clinics (~70%). Further research is required to assess the relationships between OSA, associated comorbidities, and disease outcomes. Addressing low rates of PAP adherence in this population may afford opportunities to improve health outcomes.
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