TOPLINE:
Obstructive sleep apnea (OSA) is associated with a significantly higher risk for stroke — regardless of continuous positive airway pressure (CPAP) device use — but only in White individuals, new data suggested. The study also found that stroke risk among Black individuals with OSA was lower in those who used CPAP machines vs those who didn›t.
METHODOLOGY:
- Researchers used data on 22,192 people from the Reasons for Geographic and Racial Differences in Stroke study, a US population-based cohort of Black and White individuals with no history of stroke at baseline (mean age, 64 years; 38% Black individuals).
- 11% of overall participants had provider diagnosed OSA at baseline.
- Participants were followed for a mean of 12 years.
- Researchers adjusted for demographic, socioeconomic, and stroke risk factors.
TAKEAWAY:
- During the follow-up period, 969 participants (4.4%) experienced a stroke.
- After adjusting for confounders, having high OSA risk and diagnosed OSA were associated with higher risks for incident stroke in White individuals (adjusted hazard ratio [aHR], 1.22; 95% CI, 1.01-1.47 and aHR, 1.33; 95% CI, 1.04-1.70, respectively) but not in Black individuals.
- Snoring was not associated with incident stroke in either Black or White individuals.
- Snoring was not associated with incident stroke in either Black or White individuals.
IN PRACTICE:
“These results were not what we were expecting to find since Black people have been shown to have a higher risk of stroke and are more likely to have sleep apnea than White people,” lead author Rebecca Robbins, MMSc, PhD, of Brigham and Women’s Hospital in Boston, Massachusetts, said in a news release. “Since it has been shown that Black people have more severe sleep apnea than White people and take longer to be screened and treated than White people, it’s possible that using a CPAP machine provides a greater benefit on reducing stroke risk for Black people.”
SOURCE:
Robbins was the lead and corresponding author of the study. It was published online in Neurology.
LIMITATIONS:
The current study assessed only self-reported OSA symptoms, risk, diagnosis, and treatment and did not include data on the hours of CPAP usage at night, number of days of treatment, adherence during the follow-up period, and OSA severity.
DISCLOSURES:
The study was funded by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging. Robbins received consulting income from Sonesta Hotels International, Oura Ring Ltd., Savoir Beds Ltd., Castle Hot Springs, and ByNacht GmbH. The other authors’ disclosures are listed in the original paper.
A version of this article appeared on Medscape.com.