History of obstructive sleep apnea associated with incident cognitive impairment in white but not black individuals in a US national cohort study.
History of obstructive sleep apnea associated with incident cognitive impairment in white but not black individuals in a US national cohort study.
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在美国的一项全国队列研究中，白人（而非黑人）的阻塞性睡眠呼吸暂停史与认知障碍事件相关。
DOI：
10.1016/j.sleep.2023.09.021
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发表时间：
2023
期刊：
影响因子：
4.8
通讯作者：
Aziz
中科院分区：
文献类型：
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作者：
Sawyer,RussellP;Bennett,Aleena;Blair,Jessica;Molano,Jennifer;Timmerman,Emerlee;Foster,Forrest;Karkoska,Kristine;Hyacinth,HyacinthI;Manly,JenniferJ;Howard,VirginiaJ;Petrov,MeganE;Hoffmann,ColesM;Yu,Fang;Demel,StacieL;Aziz
我们试图确定阻塞性睡眠呼吸暂停(OSA)的风险、阻塞性睡眠呼吸暂停的病史和/或OSA的治疗是否与黑人和白人中发生的认知损害或认知下降有不同的相关性。方法采用中风的地理和种族差异的原因的数据来确定OSA的风险、OSA的病史和/或治疗是否与黑人和白人的事件认知障碍或认知下降有不同的关联。参与者完成了睡眠问卷模块，接受了基线认知评估，并在后续行动中至少进行了一次认知评估。根据柏林睡眠调查问卷确定阻塞性睡眠呼吸暂停的风险。睡眠呼吸暂停病史是根据结构化访谈问题确定的。结果在19,017名按种族分层的参与者中，有OSA病史的白人参与者发生事件认知障碍的可能性是没有OSA病史的白人参与者的1.62倍，在调整了人口学特征、病史和生活方式因素后(OR=1.62，95%CI=11.05-2.50，p值=0.03)。在黑人参与者中没有发现这种关系(OR=0.92，95%CI=0.60-1.43，p值=0.72)。讨论先前诊断的阻塞性睡眠呼吸暂停与美国白人的事件认知障碍有关，但与美国黑人的事件认知障碍无关。需要进一步的研究来确定这种差异的机制。
BackgroundWe sought to determine if risk for obstructive sleep apnea (OSA), a history of OSA, and/or treatment of OSA has a different association with incident cognitive impairment or cognitive decline in Black individuals and White individuals.MethodsTo determine whether the risk for OSA, a history of OSA, and/or treatment of OSA has a different association with incident cognitive impairment or cognitive decline in Black individuals and White individuals; data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) was used. Participants that completed the sleep questionnaire module, had baseline cognitive assessment, and at least one cognitive assessment during follow-up were included. Risk of OSA was determined based on Berlin Sleep Questionnaire. History of sleep apnea was determined based on structured interview questions. Optimally treated OSA was defined as treated sleep apnea as at least 4 h of continuous positive airway pressure use per night for ≥5 nights per week.ResultsIn 19,017 participants stratified by race, White participants with history of OSA were 1.62 times more likely to have incident cognitive impairment compared to White participants without history of OSA after adjusting for demographic characteristics, history, and lifestyle factors (OR = 1.62, 95% CI = 1.05–2.50, p-value = 0.03). This relationship was not seen in Black participants (OR = 0.92, 95% CI = 0.60–1.43, p-value = 0.72).DiscussionA previous diagnosis of OSA is associated with incident cognitive impairment in White Americans but not Black Americans. Further investigations are required to determine the mechanism for this difference.