Snoring or sleep apnoea – there’s a whole world of differences involved

It’s not hard to imagine how noise, weather, an unsettled child or a bad day at work could influence how you sleep, but what about the effects of where you live, your ethnicity, your gender, your education, or even your income?

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It’s been proved there’s a complex web of interactions involved and studying the connection between ethnic groups and sleep apnea could help sleep specialists understand aspects of the condition that still remain unexplored and may help individualise the approach to different patients.

However, can a factory shift worker who comes from a non-English speaking background and lives in a rough part of town be more likely to have poorer sleep than a professional from a well-to-do suburb earning a stable income? Not withstanding the sleep-disrupting pressures that many professionals can face, the answer is very possibly yes. International research has pointed to links between disadvantaged social circumstances and poor sleep.

In the United States, the number-one risk factor by far for sleep apnea is an increase in body weight, but ethnicity may also play an important role. One key study by Pennsylvania researchers found poor sleep quality was strongly associated with both poverty and ethnicity.

The study surveyed 9,714 people on their sleeping habits and found that African-American and Latino participants demonstrated increased odds for reporting poor sleep, as did people who were unemployed, unmarried or had high stress levels.

In two presentations at the annual meeting of the Associated Professional Sleep Societies in Boston last year, scientists reported that the amount and quality of sleep people get each night vary across racial and ethnic lines, with one study showing that Afro-Americans and Asians don’t sleep as much as others, and another study showing that foreign-born Americans are less likely to report having sleep problems than those born in the U.S.A.

In a further study of patients observed at the Detroit Receiving Hospital Sleep Disorders Center, the severity of sleep apnea was shown to be higher among African-American men under 40 years old and between 50 and 59 years old. However no difference was found between African-American and other groups of women.

It was discovered also that it doesn’t take much weight gain for Asians to develop the same severity of sleep apnea compared to those of Caucasian descent. This is likely related to differences in the typical bone structure of the head and face. In other words, it takes less weight gain for many Asians to develop the repetitive obstructions during sleep behind the tongue and soft palate that happen in sleep apnea.

Access to treatment for sleep disorders has also been found to vary greatly with circumstances throughout many parts of the world.

Further research was conducted in 2015 by Dorothy Bruck, emeritus professor of psychology at Victoria University and a sleep psychologist with the Sleep Health Foundation.

“Socio-economic status is a big determinant of health in general and sleep is no exception to that,” Dr Bruck said. Aboriginal people with a confirmed sleep-related breathing disorder, for instance, were more likely than non-Indigenous sufferers of the condition to live in a remote community, the study found and they were also more likely to be younger and female.

David Hillman, a sleep physician and chair of Australia’s Sleep Health Foundation says the way factors such as socio-economic status, race, gender and other life circumstances interact with sleep is an area that warrants further research.

Dr Hillman says men are more likely to experience issues such as sleep apnoea and snoring, but women are more likely to experience disrupted sleep and insomnia in particular. He says one of the reasons for this is that women are more prone to experiencing depression, which can interfere with quality of sleep but other factors behind the difference between the genders are less clear.

We are all individuals and as a result may demand a different solution to our snoring and sleep problems, but with such a wide range of different stop snoring solutions now available online, it is much easier to get help.

John Redfern