Cardiovascular and sociocultural factors are associated with sleep breathing differences in a diverse hispanic/latino cohort.

Abstract Introduction Obesity and or obstructive sleep apnea (OSA) can impact awake breathing patterns, such as increments in the breathing rate. However, little is known about their associations with breathing dysregulations during sleep beyond the apnea-hypopnea events. Understanding this could help elucidate treatment mechanisms or different pathways for disease. Furthermore, there is a strong connection between breathing patterns and cardiovascular disease, thus it is also critical to understand the links between cardiovascular risk factors and disease (CVD) and sleep breathing patterns. Methods The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective multicenter study of diverse Latinos. A total of N=16,415 participants from four major metropolitan areas and six different Hispanic/Latino backgrounds were sampled for appropriate generalization to the target population. Participants were given an ARES unirecorder device (Carlsbad, San Diego) for a single night of unsupervised at home recording (N=12,022). Raw data from cannula channel (sampled at 10Hz) was processed using the python Bycycle package. Bycycle is a cycle-by-cycle approach to analyzing time series data. Bycycle finds all peaks and throughs in cycles and allows users to extract time dependent information of cycles. We extracted breathing rate (breaths per minute), breathing variability (interquartile range of breathing rate) and time spent in inhalation phase (percent time). Results In multivariable models (N=10,175), age was linked to decreased breathing rate, breathing variability, and time spent in inhalation phase. Compared to females, males had higher breathing variability and spent more time in the inhalation phase. Compared to Mexicans and? Central Americans, Cubans, Dominicans, and Puerto Ricans had less time spent in inhalation phase. Dominicans and Puerto Ricans also had increased breathing rate compared to Mexicans. Smoking, body mass index, and moderate to severe OSA were associated with increased breathing rate and variability. Systolic, but not diastolic blood pressure, was associated with increased breathing rate. We found no significant associations with cardiovascular disease. Conclusion Factors commonly linked to OSA were associated with increased breathing rate, a compensatory mechanism for optimal oxygenation, and breathing variability. Given cessation or reduced breathing during an apnea-hypopnea event, breathing variability may add more precision to account for varying oxygen demands. Support (if any)