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

By Cara Murez

HealthDay Reporter

WEDNESDAY, May 24, 2023 (HealthDay News) — When it comes to diagnosing sleep apnea, current screening methods may put black patients at a disadvantage, new research suggests.

Obstructive sleep apnea (OSA) is a serious sleep disorder characterized by interruption of breathing during sleep. An initial screening tool might be an overnight pulse oximeter test, a small device that is worn on the fingertip and measures oxygen levels in the blood.

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

“Although skin pigmentation appears to affect oximetry results, we didn’t know if the same would occur during OSA testing,” study co-author Ali Azarbarzin, an assistant professor of medicine at Harvard Medical School, said in Boston.

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

The researchers then examined the results of nearly 2,000 patients of different races and ethnicities who did overnight home sleep studies.

The researchers compared the participants’ average change in oxygen levels after each breathing pause using equipment that included oximeters.

The team found that black participants had a smaller decrease in oxygen saturation (oxygen level in the blood) for each pause in breathing compared to white patients. This was true after accounting for other factors that can influence blood oxygen levels, such as age, gender, body mass index (a measure based on weight and height), and smoking status.

“Our findings suggest that these measurement problems may lead to an underestimation of the severity of OSA in black people. However, it is not clear whether this underestimation of oxygen droplets should lead to important differences in the diagnosis and management of OSA in blacks and other people with dark skin,” Azarbarzin said.

“However, these findings highlight the need to rigorously test the accuracy of oximeters in diverse populations and also to consider whether factors other than oximeter characteristics might explain differences in pause-breath oxygen patterns,” he added.

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

More information

The Sleep Foundation has more about obstructive sleep apnea.

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