Widely Used Sleep Apnea Test May Overlook the Disorder in Black Patients

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A widely used test for obstructive sleep apnea may fail to detect the condition in Black patients, a gap that could influence key treatment choices.

Sleep studies commonly rely on pulse oximeters, small devices that track blood oxygen levels, to help gauge how severe sleep apnea is.

In the new research, oxygen-based scoring identified about 20% fewer breathing events in Black participants than in white participants.

By contrast, heart-rate-based scoring did not show a similar racial difference.

According to lead author Ali Azarbarzin of the Division of Sleep and Circadian Disorders at Mass General Brigham in Boston, the findings have "potential implications for diagnosis and severity classification."

Previous studies have suggested pulse oximeters may be less precise on darker skin, although the new research does not prove the device is responsible.

The researchers said a normal or borderline result in Black patients should be interpreted carefully when symptoms or other conditions point strongly to sleep apnea, such as loud snoring, gasping during sleep, daytime fatigue, or health issues including high blood pressure or diabetes.

"We are not suggesting different diagnostic thresholds based on race," Azarbarzin said in a news release. "Rather, we think the underlying measurements need to be accurate and reliable across all patients."

The study appeared in the American Journal of Respiratory and Critical Care Medicine.