Article record

阿拉伯裔、黑人和白人女性及男性中睡眠呼吸暂停与共病失眠风险：一项纵向研究

Sleep Apnea and Risk of Comorbid Insomnia in Arab, Black, and White Women and Men; A Longitudinal Study.

临床研究鼻科IF 6.6Q1

文献信息

PMID	42784281
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Galit Levi Dunietz 查看其他 9 位作者 Benjamin Osafo Agyare；Punithavathy Vijayakumar；Ron Gavidia；Xiru Lyu；Abdulghani Sankari；Hrayr Attarian；Erin Kaleba；Sonia Ancoli-Israel；Kerby Shedden
作者单位	Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48109, USA. 查看其他 6 条单位信息 Department of Statistics, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, 48109, USA.；Pulmonary & Critical Care and Sleep Medicine, School of Medicine, Wayne State University, Detroit, MI 48201, USA.；Pulmonary& Critical Care Section, John D. Dingell Department of Veteran Affairs Medical Center, Detroit, MI 48202, USA.；Department of Neurology, Division of Sleep Medicine, Feinberg School of Medicine, Northwestern University, 676 N St Clair Street #701, Chicago, Illinois 60611, USA.；Data Office for Clinical and Translational Research, University of Michigan, Ann Arbor, Michigan, 48109, USA.；Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
期刊	Sleep
SCI 分区	Q1
IF	6.6
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

研究目的： 共病失眠与睡眠呼吸暂停（COMISA）导致的健康结局比任一单一疾病更差。尽管阻塞性睡眠呼吸暂停（OSA）与失眠之间的双向联系已确立，但从OSA到新发失眠的因果轨迹——以及按性别、种族和族裔划分的潜在差异——仍研究不足。我们在一个大型、多样化的临床队列中研究了OSA与新发失眠之间的关联。
方法： 我们在密歇根大学健康系统（2012-2023年）的电子病历（EMR）中开展了一项回顾性队列研究，纳入313,953名成年人（年龄40-85岁）。参与者需在进入队列后一年内无失眠。阿拉伯族裔通过经验证的基于姓氏的算法识别，而黑人和白人身份则基于EMR自我报告。为估计OSA诊断后新发失眠的风险，我们采用了多变量Cox比例风险模型，并针对年龄、性别、种族和族裔、BMI以及区域剥夺指数（一种社会经济劣势的衡量指标）进行了校正。我们纳入了交互项，以评估OSA与失眠之间的关联是否在性别、种族和族裔亚组间存在显著差异。
结果： OSA诊断与随后发生失眠的风险显著增加相关。尽管这些关联不因性别而异，但按种族和族裔观察到显著的交互作用（交互项p<0.04）。阿拉伯裔（HR=1.57；95% CI [1.34-1.84]）和黑人患者（HR=1.57；95% CI [1.45-1.70]）的新发失眠风险高于白人患者（HR=1.39；95% CI [1.35-1.43]）。
结论： 这些发现表明，阿拉伯裔和黑人患者在OSA诊断后面临不成比例地更高的发生COMISA的风险。

英文摘要

STUDY OBJECTIVES: Comorbid insomnia and sleep apnea (COMISA) results in worse health outcomes than either condition alone. While the bidirectional link between obstructive sleep apnea (OSA) and insomnia is established, the causal trajectory from OSA to incident insomnia - and potential disparities by sex, race, and ethnicity - remains understudied. We investigated the association between OSA and incident insomnia within a large, diverse clinical cohort.
METHODS: We conducted a retrospective cohort study of 313,953 adults (aged 40-85 years) within the Electronic Medical Records (EMR) of the University of Michigan Health System (2012-2023). Participants were required to be insomnia-free for one year following cohort entry. Arab ethnicity was identified using a validated surname-based algorithm, while Black and White designations were based on EMR self-report.To estimate the risk of incident insomnia following an OSA diagnosis, we employed multivariable Cox proportional hazards models adjusted for age, sex, race and ethnicity, BMI, and Area Deprivation Index, a measure of socioeconomic disadvantage. Interaction terms were included to evaluate whether the association between OSA and insomnia differed significantly across sex, racial, and ethnic subgroups.
RESULTS: OSA diagnosis was associated with a significantly increased risk of subsequent insomnia. Although these associations did not vary by sex, significant interactions were observed according to race and ethnicity (interaction term p<0.04). Arab (HR=1.57; 95% CI [1.34-1.84]) and Black patients (HR=1.57; 95% CI [1.45-1.70]) exhibited a higher hazard of incident insomnia than White patients (HR=1.39; 95% CI [1.35-1.43]).
CONCLUSIONS: These findings demonstrate that Arab and Black patients face a disproportionately higher risk of developing COMISA following OSA diagnosis.