Black Women Show Highest Sleep Apnea Rates During REM Sleep in Major Study

Sleep apnea affects millions of Americans, but new research reveals that the condition manifests very differently across racial and ethnic groups, particularly during REM sleep stages. This groundbreaking study from the DORMIR research project examined 821 community-dwelling adults aged 50 and older, including 284 Mexican American, 174 Black, and 363 non-Hispanic White participants, using FDA-approved peripheral arterial tonometry for at-home sleep testing.

The results revealed stark disparities in REM sleep apnea patterns. Black participants showed a REM respiratory event index (REI) that was 3 events per hour higher than non-Hispanic White adults, even after controlling for demographics, socioeconomic factors, and health conditions. Black women were particularly affected, showing the highest REM-REI scores of any group, while non-Hispanic White men had the lowest. Overall, 72.7% of participants had REM sleep apnea (≥15 events/hour) compared to 39.5% with non-REM sleep apnea.

Interestingly, while REM sleep apnea showed clear racial differences, overall sleep apnea rates were similar across groups, with about 50.5% having moderate to severe OSA. Mexican American participants showed similar sleep apnea patterns to non-Hispanic White adults but had higher average blood oxygen levels during sleep. The study found no significant differences in non-REM sleep apnea across racial or ethnic groups.

These findings have important clinical implications since REM sleep apnea is associated with worse cardiovascular outcomes, cognitive decline, and metabolic dysfunction compared to non-REM sleep apnea. The research suggests that standard sleep apnea screening may miss critical disparities that could contribute to health inequities. Clinicians should pay particular attention to REM sleep patterns in Black patients, especially women, who may be at higher risk for the most harmful forms of sleep-disordered breathing.