Cardiovascular correlates of sleep apnea phenotypes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Benson Wu, Wassim Tarraf, Douglas M. Wallace, Ariana M. Stickel, Neil Schneiderman, Susan Redline, Sanjay R. Patel, Linda C. Gallo, Yasmin Mossavar-Rahmani, Martha L. Daviglus, Phyllis C. Zee, Gregory A. Talavera, Daniela Sotres-Alvarez, Hector M. González, Alberto Ramos

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Identifying Obstructive Sleep Apnea (OSA) phenotypes among middle-aged and older Hispanics/Latinos can facilitate personalized care, better inform treatment decisions, and could lead to improved clinical outcomes. METHODS: We focused on middle-aged and older adults (ages ≥45-74 years at baseline) with an apnea-hypopnea index (AHI) ≥5 from the HCHS/SOL (2008-2011) (unweighted n = 3,545). We used latent class analyses (LCA) to identify empirical and clinically meaningful OSA phenotypes. Sleep variables included AHI, percent sleep time SpO2<90%, Epworth Sleepiness Scale (ESS), Women's Health Initiative Insomnia Rating Scale (WHIIRS) score, self-reported average sleep duration, restless legs symptoms, napping frequency, and self-reported sleep quality. We used survey logistic and Poisson regression to test the associations between our OSA phenotypes and prevalent and incident cardiovascular measures (cardiovascular disease, heart failure, Stroke/TIA, hypertension, diabetes, and the Framingham Cardiovascular Risk Score). RESULTS: Average AHI, ESS, WHIIRS, and sleep duration were 18.1±19.5, 6.3±6.1, 7.4±6.6, and 7.8±1.7 hours, respectively, and 2.9% had zero percent time SpO2 <90%. We identified a three-class solution that clustered individuals into (1) insomnia OSA (44.3%), (2) asymptomatic mild OSA, (36.2%) and (3) symptomatic OSA (19.5%). Elevated WHIIRS and AHI scores primarily drove classification into groups one and three, respectively. In covariate adjusted models, OSA phenotypes were differentially associated with prevalence (baseline and seven years later) and incidence of cardiovascular measures. CONCLUSIONS: OSA subtypes in diverse U.S. Hispanic/Latino adults have different cardiovascular complications. More targeted research, that takes these variations into account, could help ameliorate Hispanic/Latino sleep and cardiovascular health disparities.

Original languageEnglish (US)
Pages (from-to)e0265151
JournalPloS one
Volume17
Issue number4
DOIs
StatePublished - 2022

ASJC Scopus subject areas

  • General

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