Format

Send to

Choose Destination
Sleep. 2019 Aug 16. pii: zsz186. doi: 10.1093/sleep/zsz186. [Epub ahead of print]

The physiological phenotype of obstructive sleep apnea differs between Caucasian and Chinese patients.

Author information

1
Department of Respiratory and Sleep Medicine, Eastern Health, Melbourne, Vic, Australia.
2
Eastern Health Clinical School, Monash University, Melbourne, Vic, Australia.
3
Sleep and Circadian Medicine Laboratory, Department of Physiology Monash University, Melbourne, Vic, Australia.
4
School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Vic, Australia.
5
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
6
School of Clinical Sciences, Monash University, Melbourne, Vic, Australia.
7
Department of Lung and Sleep, Monash Health, Melbourne, Vic, Australia.
8
Monash Partners - Epworth, Melbourne, Australia.

Abstract

STUDY OBJECTIVES:

The mechanisms responsible for the development of obstructive sleep apnea (phenotypic "traits") are known to differ between individuals and may differ across ethnicities. We aimed to examine whether loop gain, arousal threshold, pharyngeal collapsibility and muscle compensation differ between Chinese and Caucasian individuals with OSA.

METHODS:

We noninvasively determined the relative contribution of loop gain, arousal threshold, pharyngeal collapsibility and muscle compensation from the ventilatory flow pattern recorded during a standard clinical polysomnography in a cohort of age and AHI matched Caucasian and Chinese patients with moderate-severe OSA (n=90).

RESULTS:

Chinese participants had significantly more collapsible pharyngeal airways as indicated by a lower Vpassive (68.9 [51.5 - 75.2] vs. 74.0 [65.1 - 80.4] %Veupnoea, U=703, p=0.012), but less ventilatory control instability as indicated by a lower loop gain (0.60 [0.50 - 0.67] vs. 0.63 [0.57 - 0.81], U=762, p=0.043) compared to Caucasian participants. Further, multiple logistic regression analyses demonstrated that the combined pharyngeal collapsibility (Vpassive) and loop gain traits help to better explain the differences between the groups beyond upper-airway collapsibility alone. No statistically significant group differences were found in muscle compensation or arousal threshold traits between groups.

CONCLUSION:

Individuals of Chinese descent appear to have OSA that is driven much more by the relative contribution of their anatomical predisposition and to a lesser extent non-anatomical causes compared to Caucasians. Future research should focus on determining if Chinese versus Caucasian ethnicity is an important contributing factor to clinical outcomes and therapeutic responses in OSA.

KEYWORDS:

Pathophysiology; collapsibility; ethnicity; loop gain; race

PMID:
31418028
DOI:
10.1093/sleep/zsz186

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center