Racial Differences in Functional and Sleep Outcomes with Positive Airway Pressure Treatment

Area of Science:

• Sleep Medicine
• Cardiorespiratory Sleep Medicine
• Sleep Apnea Research

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition affecting millions globally.
• Positive airway pressure (PAP) is a primary treatment for moderate-to-severe OSA.
• The differential response to PAP treatment across racial groups remains under-investigated.

Purpose of the Study:

• To investigate whether race modifies the treatment effects of PAP on sleep and daytime functioning in patients with OSA.
• To compare the efficacy of PAP therapy between African American (AA) and European American (EA) individuals.

Main Methods:

• A cohort of 185 participants with moderate-to-severe OSA underwent PAP treatment.
• Sleep and daytime function were assessed using the Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire, Psychomotor Vigilance Task, and actigraphy.
• Linear regression models, including a race × PAP usage interaction term, were employed to analyze treatment outcomes.

Main Results:

• African Americans showed smaller reductions in ESS scores and fewer awakenings compared to European Americans.
• African Americans demonstrated greater improvements in wake after sleep onset and reduced frequency of awakenings with increased PAP usage.
• Race significantly influenced the changes in sleep quality and daytime function observed after PAP treatment.

Conclusions:

• Race is a significant factor influencing treatment outcomes in patients with obstructive sleep apnea undergoing PAP therapy.
• Clinical evaluations of PAP treatment efficacy should consider racial differences to optimize patient care.
• Further research is warranted to understand the underlying mechanisms driving these racial disparities in PAP treatment response.