What are the racial predilections of obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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African American individuals appear to be more predisposed to SDB than white persons. This increased predisposition varies according to age. The odds ratio is greater than 3 in children younger than 13 years and is 1.88 in persons younger than 25 years. In elderly African Americans, the risk is increased 2-fold. Examination of craniofacial morphology found that brachycephaly is associated with an increased AHI in whites but not in African Americans. [27]

Chinese patients with OSA have a more crowded upper airway and relative retrognathia compared with their white counterparts, with statistical controls for BMI and neck circumference. [9] Asians are known to have a shorter cranial base and a more acute cranial base flexure, increasing OSA risk, with BMI and neck circumference being roughly equal. Therefore, interestingly, obesity plays a more prominent role in OSA predisposition in whites than in Chinese persons. This may serve to underscore the role that craniofacial factors have in Chinese patients.

Other populations that may be at increased risk include Mexican Americans and Pacific Islanders.

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