Standard tests may underestimate the severity of sleep apnea in black patients

Written by Cara Murez

Health Day reporter

WEDNESDAY, May 24, 2023 (HealthDay News) — Current screening methods for diagnosing sleep apnea may disadvantage black patients, new research suggests.

Obstructive sleep apnea (OSA) is a serious sleep disorder characterized by breathing disorders during sleep. The initial screening tool may be an overnight pulse oximeter test—a small device clipped to the fingertip that measures oxygen levels in the blood.

The researchers began this study after seeing research showing that pulse oximeters used on intensive care unit patients during the COVID-19 pandemic were less accurate in black patients than in white patients.

“Although skin pigmentation appears to influence oximetry results, we did not know if this would be true in OSA tests,” said study co-author Ali Azarbarzin, assistant professor of medicine at Harvard Medical School in Boston.

“We hypothesized that this would be the case,” Azarbarzin said in an American Thoracic Society news release.

So the researchers looked at the results of nearly 2,000 patients of different races and ethnicities who completed nightly home sleep studies.

The researchers compared the average change in the participants’ oxygen levels after each breath pause using a device containing oximeters.

The team found that the black participants’ oxygen saturation — the level of oxygen in the blood — decreased less with each breath pause than the white patients. This was true after taking into account other factors that can affect blood oxygen levels, including age, gender, body mass index (a measurement based on weight and height) and smoking.

“Our findings suggest that these measurement issues may lead to an underestimation of the severity of OSA in black individuals. However, it is unclear whether such underestimation of oxygen droplets leads to significant differences in the diagnosis and management of OSA in blacks and other dark-skinned individuals,” Azarbarzin said.

“Nevertheless, these results point to the need to rigorously test the accuracy of oximeters in different populations and to consider whether factors other than oximeter characteristics may explain differences in oxygenation patterns associated with respiratory pauses,” he added.

The findings were scheduled to be presented Tuesday at the American Thoracic Society’s annual meeting in Washington, DC. Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.

More information

The Sleep Foundation covers more about obstructive sleep apnea.

SOURCE: American Thoracic Society, press release, May 23, 2023