title: Sleep-disordered breathing in Hispanic/Latino individuals of diverse backgrounds. The Hispanic Community Health Study/Study of Latinos.
abstract: BACKGROUND
  Hispanic/Latino populations have a high prevalence of cardiovascular risk factors and may be at risk for sleep-disordered breathing (SDB). An understanding of SDB among these populations is needed given evidence that SDB increases cardiovascular risk.
  
  
  OBJECTIVE
  To quantify SDB prevalence in the U.S. Hispanic/Latino population and its association with symptoms, risk factors, diabetes, and hypertension; and to explore variation by sex and Hispanic/Latino background.
  
  
  METHODS
  Cross-sectional analysis from the baseline examination of the Hispanic Community Health Study/Study of Latinos.
  
  
  RESULTS
  The apnea-hypopnea index (AHI) was derived from standardized sleep tests; diabetes and hypertension were based on measurement and history. The sample of 14,440 individuals had an age-adjusted prevalence of minimal SDB (AHI ≥ 5), moderate SDB (AHI ≥ 15), and severe SDB (AHI ≥ 30) of 25.8, 9.8, and 3.9%, respectively. Only 1.3% of participants reported a sleep apnea diagnosis. Moderate SDB was associated with being male (adjusted odds ratio, 2.7; 95% confidence interval, 2.3-3.1), obese (16.8; 11.6-24.4), and older. SDB was associated with an increased adjusted odds of impaired glucose tolerance (1.7; 1.3-2.1), diabetes (2.3; 1.8-2.9), and hypertension. The association with hypertension varied across background groups with the strongest associations among individuals of Puerto Rican and Central American background.
  
  
  CONCLUSIONS
  SDB is prevalent in U.S. Latinos but rarely associated with a clinical diagnosis. Associations with diabetes and hypertension suggest a large burden of disease may be attributed to untreated SDB, supporting the development and evaluation of culturally relevant detection and treatment approaches.
authors.affiliation: 1 Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Daniela
authors.initials: D
authors.lastname: Sotres-Alvarez
authors.forename: Jose
authors.initials: J
authors.lastname: Loredo
authors.forename: Martica
authors.initials: M
authors.lastname: Hall
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Patel
authors.forename: Alberto
authors.initials: A
authors.lastname: Ramos
authors.forename: Neomi
authors.initials: N
authors.lastname: Shah
authors.forename: Andrew
authors.initials: A
authors.lastname: Ries
authors.forename: Raanan
authors.initials: R
authors.lastname: Arens
authors.forename: Janice
authors.initials: J
authors.lastname: Barnhart
authors.forename: Marston
authors.initials: M
authors.lastname: Youngblood
authors.forename: Phyllis
authors.initials: P
authors.lastname: Zee
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology / Q000209:etiology; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult