Differences in respiratory arousal threshold in Caucasian and Chinese patients with obstructive sleep apnoea

Richard W.W. Lee, Kate Sutherland, Scott A. Sands, Bradley A. Edwards, Tat on Chan, Susanna S.S. Ng, David S C Hui, Peter A. Cistulli

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

Background and objective: Ethnic differences in obstructive sleep apnoea (OSA) phenotype may not be limited to obesity and craniofacial factors. The aims of the study were to (i) compare the proportion of Caucasians and Chinese patients with a low respiratory arousal threshold (ArTH) and (ii) explore the influence of anatomical compromise on ArTH. Methods: Interethnic comparison was conducted between cohorts of Caucasian and Chinese patients from specialist sleep disorder clinics. Polysomnography and craniofacial photography were performed. A low respiratory ArTH was determined by an ArTH score of 2 or above (one point for each: apnoea–hypopnoea index (AHI) < 30/h, nadir oxygen saturation (SaO2) > 82.5%, fractions of hypopnoeas > 58.3%). Anatomical compromise was stratified according to the photographic face width measurement. Results: A total of 348 subjects (163 Caucasians and 185 Chinese) were analysed. There was a significantly lower proportion of Chinese patients with moderate-severe OSA (AHI ≥ 15) who had a low ArTH (28.4% vs 48.8%, P = 0.004). This difference remained significant among those with severe OSA (AHI ≥ 30) (2.6% vs 17.1%, P = 0.02). The proportion of moderate-severe OSA Caucasians with a low ArTH was significantly less in those with severe anatomical compromise (36.6% vs 61.0%, P = 0.03), whereas there was no difference in Chinese patients (25.5% vs 31.5%, P = 0.49). Conclusion: Compared to Caucasians with severe OSA, a low respiratory ArTh appears to be a less common pathophysiological mechanism in Chinese patients. Caucasians with less severe anatomical compromise exhibit evidence of a lower ArTh, an association which is absent in Chinese patients. Our data suggest that OSA mechanisms may vary across racial groups.

Original languageEnglish
Pages (from-to)1015-1021
Number of pages7
JournalRespirology
Volume22
Issue number5
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • anatomical compromise
  • ethnicity
  • facial anatomy
  • obstructive sleep apnoea
  • respiratory arousal threshold

Cite this

Lee, Richard W.W. ; Sutherland, Kate ; Sands, Scott A. ; Edwards, Bradley A. ; Chan, Tat on ; S.S. Ng, Susanna ; Hui, David S C ; Cistulli, Peter A. / Differences in respiratory arousal threshold in Caucasian and Chinese patients with obstructive sleep apnoea. In: Respirology. 2017 ; Vol. 22, No. 5. pp. 1015-1021.
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title = "Differences in respiratory arousal threshold in Caucasian and Chinese patients with obstructive sleep apnoea",
abstract = "Background and objective: Ethnic differences in obstructive sleep apnoea (OSA) phenotype may not be limited to obesity and craniofacial factors. The aims of the study were to (i) compare the proportion of Caucasians and Chinese patients with a low respiratory arousal threshold (ArTH) and (ii) explore the influence of anatomical compromise on ArTH. Methods: Interethnic comparison was conducted between cohorts of Caucasian and Chinese patients from specialist sleep disorder clinics. Polysomnography and craniofacial photography were performed. A low respiratory ArTH was determined by an ArTH score of 2 or above (one point for each: apnoea–hypopnoea index (AHI) < 30/h, nadir oxygen saturation (SaO2) > 82.5{\%}, fractions of hypopnoeas > 58.3{\%}). Anatomical compromise was stratified according to the photographic face width measurement. Results: A total of 348 subjects (163 Caucasians and 185 Chinese) were analysed. There was a significantly lower proportion of Chinese patients with moderate-severe OSA (AHI ≥ 15) who had a low ArTH (28.4{\%} vs 48.8{\%}, P = 0.004). This difference remained significant among those with severe OSA (AHI ≥ 30) (2.6{\%} vs 17.1{\%}, P = 0.02). The proportion of moderate-severe OSA Caucasians with a low ArTH was significantly less in those with severe anatomical compromise (36.6{\%} vs 61.0{\%}, P = 0.03), whereas there was no difference in Chinese patients (25.5{\%} vs 31.5{\%}, P = 0.49). Conclusion: Compared to Caucasians with severe OSA, a low respiratory ArTh appears to be a less common pathophysiological mechanism in Chinese patients. Caucasians with less severe anatomical compromise exhibit evidence of a lower ArTh, an association which is absent in Chinese patients. Our data suggest that OSA mechanisms may vary across racial groups.",
keywords = "anatomical compromise, ethnicity, facial anatomy, obstructive sleep apnoea, respiratory arousal threshold",
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Differences in respiratory arousal threshold in Caucasian and Chinese patients with obstructive sleep apnoea. / Lee, Richard W.W.; Sutherland, Kate; Sands, Scott A.; Edwards, Bradley A.; Chan, Tat on; S.S. Ng, Susanna; Hui, David S C; Cistulli, Peter A.

In: Respirology, Vol. 22, No. 5, 01.07.2017, p. 1015-1021.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Differences in respiratory arousal threshold in Caucasian and Chinese patients with obstructive sleep apnoea

AU - Lee, Richard W.W.

AU - Sutherland, Kate

AU - Sands, Scott A.

AU - Edwards, Bradley A.

AU - Chan, Tat on

AU - S.S. Ng, Susanna

AU - Hui, David S C

AU - Cistulli, Peter A.

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N2 - Background and objective: Ethnic differences in obstructive sleep apnoea (OSA) phenotype may not be limited to obesity and craniofacial factors. The aims of the study were to (i) compare the proportion of Caucasians and Chinese patients with a low respiratory arousal threshold (ArTH) and (ii) explore the influence of anatomical compromise on ArTH. Methods: Interethnic comparison was conducted between cohorts of Caucasian and Chinese patients from specialist sleep disorder clinics. Polysomnography and craniofacial photography were performed. A low respiratory ArTH was determined by an ArTH score of 2 or above (one point for each: apnoea–hypopnoea index (AHI) < 30/h, nadir oxygen saturation (SaO2) > 82.5%, fractions of hypopnoeas > 58.3%). Anatomical compromise was stratified according to the photographic face width measurement. Results: A total of 348 subjects (163 Caucasians and 185 Chinese) were analysed. There was a significantly lower proportion of Chinese patients with moderate-severe OSA (AHI ≥ 15) who had a low ArTH (28.4% vs 48.8%, P = 0.004). This difference remained significant among those with severe OSA (AHI ≥ 30) (2.6% vs 17.1%, P = 0.02). The proportion of moderate-severe OSA Caucasians with a low ArTH was significantly less in those with severe anatomical compromise (36.6% vs 61.0%, P = 0.03), whereas there was no difference in Chinese patients (25.5% vs 31.5%, P = 0.49). Conclusion: Compared to Caucasians with severe OSA, a low respiratory ArTh appears to be a less common pathophysiological mechanism in Chinese patients. Caucasians with less severe anatomical compromise exhibit evidence of a lower ArTh, an association which is absent in Chinese patients. Our data suggest that OSA mechanisms may vary across racial groups.

AB - Background and objective: Ethnic differences in obstructive sleep apnoea (OSA) phenotype may not be limited to obesity and craniofacial factors. The aims of the study were to (i) compare the proportion of Caucasians and Chinese patients with a low respiratory arousal threshold (ArTH) and (ii) explore the influence of anatomical compromise on ArTH. Methods: Interethnic comparison was conducted between cohorts of Caucasian and Chinese patients from specialist sleep disorder clinics. Polysomnography and craniofacial photography were performed. A low respiratory ArTH was determined by an ArTH score of 2 or above (one point for each: apnoea–hypopnoea index (AHI) < 30/h, nadir oxygen saturation (SaO2) > 82.5%, fractions of hypopnoeas > 58.3%). Anatomical compromise was stratified according to the photographic face width measurement. Results: A total of 348 subjects (163 Caucasians and 185 Chinese) were analysed. There was a significantly lower proportion of Chinese patients with moderate-severe OSA (AHI ≥ 15) who had a low ArTH (28.4% vs 48.8%, P = 0.004). This difference remained significant among those with severe OSA (AHI ≥ 30) (2.6% vs 17.1%, P = 0.02). The proportion of moderate-severe OSA Caucasians with a low ArTH was significantly less in those with severe anatomical compromise (36.6% vs 61.0%, P = 0.03), whereas there was no difference in Chinese patients (25.5% vs 31.5%, P = 0.49). Conclusion: Compared to Caucasians with severe OSA, a low respiratory ArTh appears to be a less common pathophysiological mechanism in Chinese patients. Caucasians with less severe anatomical compromise exhibit evidence of a lower ArTh, an association which is absent in Chinese patients. Our data suggest that OSA mechanisms may vary across racial groups.

KW - anatomical compromise

KW - ethnicity

KW - facial anatomy

KW - obstructive sleep apnoea

KW - respiratory arousal threshold

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U2 - 10.1111/resp.13022

DO - 10.1111/resp.13022

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VL - 22

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