Andrew Mettias,1 Kaela Iwai,2 Krystalyn Edwards-Calma,1 Hannah Miura,1 D-Dré D. Wright,1,2 Ryan Nakamura,2 Anita J. Cheung,2 Nicholas Anderson,2 Kore Liow,1,2 Enrique Carrazana2
1 Hawaii Sleep and Wake Center, Hawaii Pacific Neuroscience, Honolulu, HI
2 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
Introduction: NHPI populations experience disproportionate levels of obstructive sleep apnea (OSA), traditionally linked to higher comorbidity rates and socioeconomic challenges. This study investigates the relationships between BMI, apnea-hypopnea index (AHI) scores, and adherence to PAP therapy, comparing Hawaii’s NHPI populations to its White and Asian populations.
Methods: A retrospective chart review of 340 patients diagnosed with OSA at Hawaii Pacific Neuroscience was performed. Three relationships were analyzed: BMI-AHI score, adherence-AHI score, and a census-derived zipcode analysis. Significance for categorical variables was determined using a Chi-squared test, while the Mann Whitney U test (Wilcoxon rank-sum) and Kruskal-Wallis rank sum test were used for continuous variables.
Results: BMI was significantly associated with OSA severity across all ethnoracial groups, with NHPI patients demonstrating elevated AHI scores and BMI (p = 0.013). The BMI-AHI relationship exhibited consistent slopes across groups. Additionally, NHPI patients exhibited higher adherence as AHI worsened compared to White and Asian patients (p < 0.001). Other than employment rate among NHPI patients (p = 0.007), no other socioeconomic factors exhibited notable associations.
