Asthma and Obstructive Sleep Apnea Overlap in a Sample of Older American Indian Adults: The Strong Heart Study

Study Objectives: Our study aimed to investigate the association between asthma and obstructive sleep apnea (OSA) in American Indian communities, a historically underrepresented population in clinical research with a high prevalence of asthma and OSA risk factors like smoking and obesity. Methods: This cross-sectional study used data retrieved from the Strong Heart Study cohort. Participants who attended both the Asthma Sub-study and the Sleep Heart Health Study around the same time were compared for active asthma diagnosis, OSA diagnosis, and potential risk factors for asthma and OSA. The association between asthma and OSA was then evaluated. Results: Among the 2480 participants who attended the Strong Heart Study Phase III exam, 123 participated in both the Asthma Sub-study and the Sleep Heart Health Study. Of these, 13 were diagnosed with OSA, with 4 having moderate to severe OSA. There was no statistically significant difference in OSA prevalence between the active asthma group and the non-active asthma group (former asthma or no asthma) (9.6% vs. 12.5%, p = 0.63). Additionally, body mass index did not differ significantly between participants with both active asthma and OSA and those without active asthma, OSA, or both. OSA diagnosis was significantly associated with male sex (Odds Ratio [OR] 9.2 [1.85-45.87], p = 0.007) and body mass index (OR 1.1 [1.02-1.26], p = 0.016) but not with age or a diagnosis of active asthma. Conclusions: In this American Indian cohort, no significant difference in OSA prevalence was observed between participants with and without active asthma, contradicting previous studies. Further research is needed to explore the underlying reasons for this discrepancy.