We know that obstructive sleep apnea generally is associated with Alzheimer’s disease risk. And we know that obstructive sleep apnea, in terms of its burden or prevalence, is higher in understudied or what we would refer to in the U.S. as minoritized groups, and these would include non-Hispanic Blacks, Hispanics, Asian and Pacific Islanders, and Native Americans. So they have a higher burden of this disorder, and Alzheimer’s disease or dementia in general, they also bear a disproportionate burden of it...
We know that obstructive sleep apnea generally is associated with Alzheimer’s disease risk. And we know that obstructive sleep apnea, in terms of its burden or prevalence, is higher in understudied or what we would refer to in the U.S. as minoritized groups, and these would include non-Hispanic Blacks, Hispanics, Asian and Pacific Islanders, and Native Americans. So they have a higher burden of this disorder, and Alzheimer’s disease or dementia in general, they also bear a disproportionate burden of it. When we look at sex-specific prevalences, we do see that with AD or Alzheimer’s disease, females will have a higher burden generally, and it could be due to many factors. When we look at obstructive sleep apnea, males would generally have a higher burden, and then when we look at other aspects, we can see sex-specific effects, with respect to when does the apnea occur? Is it in non-REM, that’s non-rapid eye movement sleep, or in rapid eye movement sleep, or whether you have respiratory effort-related arousals? So there are sex differences in that. Women would typically have more REM OSA, while men would have generally more prevalence and burden of OSA. So looking at that, the process was to look at could there be physiologic mechanisms by which OSA increases Alzheimer’s disease risk that is race or sex related or associated. So this was a longitudinal study so we looked at what we call race-specific effects in terms of fragmentation measures, in terms of duration measures, or hypoxic measures, hypoxic burden or measures with respect to obstructive sleep apnea. And what we do see is that across all of these mechanisms, whether it’s hypoxia or disordered breathing measures, duration measures, or fragmentation measures, you do see that across all racial ethnic groups, they do increase, especially at the extremes, will increase the risk for Alzheimer’s disease, incident Alzheimer’s disease. Because this was a follow-up between 10 and 13 years, an average of 8.5 years. But then when we looked at between racial ethnic groups, we now begin to see the effects very strong or stronger relative to non-Hispanic white in duration and continuity measures, as well as in hypoxia or disordered breathing measures. When we look at sex-specific effects, we see females having very strong estimates relative to males in fragmentation measures. And then in the hypoxia or disordered breathing measures, males having a stronger effect related to females generally. So the thought process is, you know, these specific mechanisms, right, may also play a role in the race and sex disparate effects that we see on the way obstructive sleep apnea impacts Alzheimer’s disease risk and could contribute to some of these race disparities or sex-specific disparities that we see, especially in individuals who have obstructive sleep apnea.
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