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Comparative Study
. 2017 May:33:97-102.
doi: 10.1016/j.sleep.2016.01.010. Epub 2016 Feb 12.

High prevalence of poststroke sleep-disordered breathing in Mexican Americans

Lynda D Lisabeth  1 , Brisa N Sánchez  2 , Ronald D Chervin  3 , Lewis B Morgenstern  4 , Darin B Zahuranec  5 , Susan D Tower  6 , Devin L Brown  5
Affiliations
Comparative Study

High prevalence of poststroke sleep-disordered breathing in Mexican Americans

Lynda D Lisabeth et al. Sleep Med. 2017 May.

Abstract

Objective: The purpose of this study is to compare sleep-disordered breathing (SDB) prevalence and severity after stroke between Mexican Americans (MAs) and non-Hispanic whites (NHWs).

Patients/methods: Ischemic stroke (IS) patients within ∼30 days of onset were identified from the population-based BASIC Project (2010-2014) and offered screening with an overnight cardiopulmonary monitoring device, ApneaLink Plus™. The number of apneas and hypopneas per hour, as reflected by the apnea/hypopnea index (AHI), was used to measure SDB severity; SDB was defined as AHI ≥10. Ethnicity, demographics, and risk factors were collected from interviews and medical records. Log and negative-binomial regression models were used to determine prevalence ratios (PRs) and apnea/hypopnea event rate ratios (RRs) comparing MAs with NHWs after adjustment for demographics, risk factors, and stroke severity.

Results: A total of 549 IS cases had AHI data. The median age was 65 years (interquartile range (IQR): 57-76), 55% were men, and 65% were MA. The MAs had a higher prevalence of SDB (68.5%) than NHWs (49.5%) in unadjusted (PR = 1.38; 95% confidence interval (CI): 1.14-1.67) and adjusted analyses (PR = 1.21; 95% CI: 1.01-1.46). The median AHI was 16 (IQR: 7-31) in MAs and nine (IQR: 5-24) in NHWs. The severity of SDB (rate of apneas/hypopneas) was higher in MAs than NHWs in unadjusted (RR = 1.31; 95% CI: 1.09-1.58) but not adjusted analysis (RR = 1.14; 95% CI: 0.95-1.38). There was no ethnic difference in severity among subjects with SDB.

Conclusion: More than two-thirds of MA stroke patients had SDB, which was almost 40% more common among MAs than NHWs. Physicians treating MA patients after stroke should have a high index of suspicion for SDB, a treatable condition that could otherwise have adverse impact.

Keywords: Ethnicity; Sleep-disordered breathing; Stroke.

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Conflict of interest statement

Conflict of interest

The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2016.01.010.

Figures

Fig. 1
Fig. 1
Distribution of Apnea–Hypopnea Index (AHI) by Ethnicity (MA = Mexican American, NHW = non-Hispanic white).
Fig. 2
Fig. 2
Distribution of Apnea–Hypopnea Index (AHI) by Ethnicity (MA = Mexican American, NHW = non-Hispanic white) Among Those with Sleep Apnea.
See this image and copyright information in PMC

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