Obstructive Sleep Apnea in African Americans: A Literature Review

Purpose of Review Untreated obstructive sleep apnea is associated with increased all-cause mortality, cardiovascular, cerebrovascular, and metabolic diseases. Obtructive sleep apnea disproportionately affects the African American community with reports of younger age of onset, increased severity of disease, and higher prevalence compared to Caucasians. The purpose of this review is to explore the degree to which heredity and social determinants of health affect obstructive sleep apnea prevalence, presentation, and outcomes. Recent Findings Recent studies have found obstructive sleep apnea characteristics in African Americans that informs putative mechanisms that drive the observed differences. These factors include reduced role of obesity, a tendency towards a lower respiratory arousal threshold, and the higher burden of inflammatory environmental exposures. Summary The difference in disease burden and adverse outcomes of obstructive sleep apnea experienced by African Americans is multifactorial and involves an intricate relationship between social determinants of health with genetic, anatomic, and physiologic factors. These influences have implications on the reliability of obstructive sleep apnea screening tools, disease presentation, and treatment success.