title: The influence of race on the severity of sleep disordered breathing.
abstract: BACKGROUND
  Studies have indicated that the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) is similar between white and African American patients, but it is unclear if there are differences in the severity of OSAHS. We hypothesized that in patients with diagnosed OSAHS, African Americans would have higher apnea-hypopnea index (AHI) and higher mortality than white individuals.
  
  
  METHODS
  We analyzed a prospectively collected database of 512 patients studied between July 1996 through February 1999. Inclusion criteria included age ≥ 18 y, AHI ≥ 5/h, and full-night PSG. Statistical analysis was performed to determine the association between race and AHI while controlling for the effect of confounders and effect modifiers, which included gender, age, body mass index, and comorbidities.
  
  
  RESULTS
  The database included 340 African American and 172 white patients. AHI was higher in African American patients (median 32.7/h IQR 3.3-69.2) than white patients (22.4/h IQR 12.8-40.6, p = 0.01). Age, sex, and BMI were found to be effect modifiers and were included in final models. In the final model, African American men younger than 39 years and between 50 and 59 years were found to have a higher AHI than white men in the same age ranges.
  
  
  CONCLUSIONS
  African American men younger than 39 years and between 50 and 59 years have a higher AHI compared to white men of the same ages after correcting for confounders and effect modifiers. There was no difference in mortality between African Americans and whites with OSAHS in this cohort.
authors.affiliation: Sleep Disorders Center at Detroit Receiving Hospital, Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Sukanya
authors.initials: S
authors.lastname: Pranathiageswaran
authors.forename: M Safwan
authors.initials: MS
authors.lastname: Badr
authors.forename: Richard
authors.initials: R
authors.lastname: Severson
authors.forename: James A
authors.initials: JA
authors.lastname: Rowley
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D044465:White People / Q000706:statistics & numerical data*
keywords: Mortality; race; sleep disordered breathing