Respiratory-Related Sleep Disorders Section
Reducing racial disparities in sleep apnea
For example, a growing body of research has shown that black race is associated with underdiagnosis of OSA, greater disease severity at time of diagnosis and reduced PAP adherence (Hsu N, et al. J Clin Sleep Med. 2020;16[8]:1249; Thornton JD, et al. Ann Am Thorac Soc. 2022;19[2]:272).
Dr. Swetha Gogineni
A recent article (Billings ME, et al. Chest. 2021;159[3]:1232) offered potential strategies to mitigate racial disparities in sleep apnea management. To expand access to care, they advocate embracing telemedicine for those who may have difficulty coming to clinic – due to transportation issues, arranging sufficient time off work, or residing in remote locations. On the other hand, an over-reliance on telemedicine has the potential to worsen disparities in populations whose access to technology is limited.
Dr. Lauren Tobias
The authors also recommend inpatient screening of high-risk patient populations to detect disease earlier and to help facilitate referrals to a sleep center. They propose the idea of “peer buddies” of similar racial and socioeconomic backgrounds to provide support and counseling, while cautioning against overburden these populations. Finally, they propose broadening the sleep provider workforce by training primary care providers to manage OSA.
The higher proportion of nonwhite providers in these groups as compared with sleep specialists may improve care, since concordant race provision has been associated with better communication. Underlying these interventions is the need to diversify representation within the medical field at large.
Swetha Gogineni, MD, Vice-Chair
Lauren Tobias, MD, Member-at-Large