More Sleep Apnea in African Americans

Sleep Apnea is more common in African Americans

More Sleep Apnea in African AmericansA recent study confirmed there is more sleep apnea in African Americans than in Whites. Sleep apnea (also call Obstructive Sleep Apnea / “OSA”) is a condition where people repeatedly stop breathing while they sleep.  The outcome is a very poor sleep cycle and interrupted sleep.  The lost sleep leads to daytime sleepiness, fatigue, poor concentration, poor energy, increased high blood pressure, heart disease, poor digestion and metabolism, and more.

Scientists found significantly increased sleep apnea patterns, more snoring, more obesity, and poor global functioning in African Americans.  The same study also showed decreased formally diagnosed sleep apnea in African Americans despite the disproportional increased occurrence.

African Americans have a poorer sleep quality overall associated with worse insomnia levels and the highest levels for excessive daytime sleepiness. That can cause difficulty at work, trouble watching movies without falling asleep, difficulty with drowsiness while driving, and so on.  With prolonged loss of sleep, high blood pressure results and with that the increased risk for stroke, heart attack, and sudden death from abnormal heart rhythms.

But CPAP fixes this.

Continuous Positive Airway Pressure CPAP therapy reduces daytime sleepiness, improves depression and quality of life, and reduces deaths.  Overall only about half of people with sleep apnea and have a CPAP machine, use it.  African Americans were over 5 times more likely to not use their CPAP machine than White Americans.

Because modern CPAP machines can monitor (and transmit data) about usage and sleep efficiency. they were able to determine that African Americans that wore the CPAP machine average one full hour less of nightly sleep.

Sleep Apnea in African Americans

Like many health problems, African Americans show significant improvement in CPAP usage when they understand how it works . . . and why it works.  A large study found that only about a quarter (26%) of African Americans were using their CPAP machine at 2 weeks compared to almost half  (47%) of Whites.  They also found that adjusting for income, demographics, and other diseases had no impact on its use.

The finding that AAs with more severe OSA were 3 times more likely to use CPAP than those with mild or moderate OSA possibly is due to subjectively perceived effectiveness.  In focus groups, AA patients said that even with the inconveniences of CPAP, they would use the device if they thought of it as helpful.   AAs with mild or moderate conditions may
not perceive that CPAP is useful.

The study also failed to show a correlation between socioeconomic status in African Americans and CPAP usage . . . there was no difference between wealthier and more educated African Americans and poorer less educated African Americas in terms of compliance and usage.  All were poor.

What makes African Americans avoid CPAP therapy?

The only thing that increased use of CPAP therapy in African Americans was having more severe sleep apnea.  The more severe the episodes of not breathing, the higher the use of the CPAP machine.  In mild and moderate sleep apnea, the patients may not trust their doctor enough to take their advice . . . this could explain the disparity.

I find that my patients prefer a Tap Pap CPAP mask that only goes into the nostrils and is held in place by your upper teeth.

Sleep Apnea in African Americans

This “mask” allows more sleeping on your side and is far more comfortable.  Wearing the CPAP at night and getting a restful nights’ sleep is essential for health.  People are shocked to hear that their heart is enlarged and may be barely functioning all due to poor sleep . . . and wear CPAP therapy can potentially reverse it!

Don’t take a good night’s sleep for granted and ask your sleeping partners about snoring and gaps in breathing.  It could literally save your life.

Salt Sensitivity and Your Health

Salt Sensitivity and Your Health

Salt sensitivity is defined as significant changes in blood pressure in response to salt in a diet.  75 percent of all African American patients with high blood pressure are salt sensitive compared to 50 percent across all races with hypertension.  The vast majority of African American patients with hypertension are salt sensitive and their salt use needs to be discussed and investigated.

Studies have consistently found salt sensitivity increases with age, and is more common in people that are overweight, have a history of “heart problems,” and have serious kidney problems . . . all of which are increased in African Americans.

Studies have additionally found that salt-sensitivity alone is associated with increased death, even in salt-sensitive people who don’t have high blood pressure.

Many foods found in African American homes are high in salt including:

  • Canned Soup
  • Vegetable Juices
  • Bouillon cubes
  • Gravies
  • Soy Sauce
  • Olives
  • Pickles
  • Canned Vegetables
  • Barbecue Sauce
  • Ketchup & Mustard
  • Ready-to-Eat Breakfast Cereal
  • Bread & Rolls
  • Pancakes & Waffles
  • Pizza
  • Processed Nuts
  • Chinese Restaurant Fast Food
  • Spaghetti Sause
  • Cold Cuts
  • Cheese
  • Bacon
  • Hot Dogs & Sausages
  • Salad Dressings & Marinades
  • Smoked meats
  • Ham
  • Raw Chicken Breasts (they are frequently injected with a high sodium flavoring solution)
  • Store-bought Baked Goods

Researchers have also found that being overweight make salt-sensitivity worse.

The increased salt sensitivity is also made worse by having a low potassium.  A study from Columbia University in New York showed “salt sensitivity in Blacks may be worsened by dietary deficiencies in potassium or a need for increased potassium requirements compared with whites.”

What can I do to fix this?

A modest reduction in salt intake (half normal consumption: 5 to 6 grams) for a month has been shown to make significant and sustained reductions in blood pressure.  In fact, African Americans showed the most pronounced blood pressure reductions in response to salt restriction with a drop of 8 mm Hg systolic (the first number in a blood pressure reading) over 4 mm Hg diastolic (the second number in a blood pressure reading) averaged across as array of studies.  Imagine what a bigger salt restriction would do?

The lower blood pressure readings in African Americans after dietary salt restriction is significant and can be maintained over time. Try these Lays Potato Chips with half the salt rather than the regular.

Take the time to look for lower sodium alternatives for seasonings and use other seasonings like garlic power, onion powder, and cayenne & black peppers. 

If you are hesitant to start a medication to bring down your mildly elevated blood pressure, spend some time looking at how much salt is in your diet, and then try to decrease this by half.