Sleep disorders are more common in racial/ethic minorities

According to a recent study, sleep disturbances occur more frequently in middle-aged and older adults who are racial or ethnic minorities.

A new study suggests that sleep disturbances and undiagnosed sleep apnea are common among middle-aged and older adults in the U.S., and these sleep problems occur more frequently among racial/ethnic minorities.

Results show that 34 percent of participants had moderate or severe sleep-disordered breathing measured by polysomnography, and 31 percent had short sleep duration with less than 6 hours per night measured by actigraphy. Validated questionnaires also showed that 23 percent reported having insomnia, and 14 percent reported excessive daytime sleepiness. Only 9 percent of participants reported being told by a doctor that they had sleep apnea.

After adjustment for sex, age, and study site, blacks were most likely to have short sleep duration of less than six hours, and they were more likely than whites to have sleep apnea syndrome, poor sleep quality, and daytime sleepiness. Hispanics and Chinese were more likely than whites to have sleep-disordered breathing and short sleep duration, but Chinese were least likely to report having insomnia.

"Our findings underscore the very high prevalence of undiagnosed sleep disturbances in middle-aged and older adults, and identify racial/ethnic disparities that include differences in short sleep duration, sleep apnea and daytime sleepiness," said lead author Dr. Xiaoli Chen, research fellow in the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston.

Study results are published in the June issue of the journalSleep.

The study population was recruited from six U.S. communities and comprised 2,230 racially/ethnically diverse men and women who were between the ages of 54 and 93 years. Data gathered by polysomnography, actigraphy and validated questionnaires were obtained between 2010 and 2013.

According to Dr. Chen and her colleagues, this is the first study that has comprehensively evaluated objective measures of sleep apnea, short sleep, and poor sleep, as well as subjective measures of habitual snoring, insomnia, and daytime sleepiness in a multi-ethnic U.S. population that includes Chinese Americans. Results suggest that sleep disturbances may contribute to health disparities among U.S. adults.

"As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations," said senior author Dr. Susan Redline, professor of medicine at Harvard Medical School and Division of Sleep Medicine at Brigham and Women's Hospital and Beth Israel Deaconess Medical Center in Boston. The study was supported by grants from the National Institutes of Health (NIH) and an award from the National Center for Advancing Translational Sciences (NCATS).

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Study: Association between autism risk and a mother's birth place

A study claims that there is an association between a child's autism risk and where his or her mother was born.

A mother's birthplace may affect her children's risk of developing an autism spectrum disorder, according to new research.

Children of foreign-born black, Central and South American, Filipino and Vietnamese mothers were more likely to have an autism spectrum disorder (ASD) compared to children born to white mothers who were born in the United States, the study found.

"The rates [of ASDs] in the African immigrants was the highest," said lead researcher Dr. Beate Ritz, chair of epidemiology at the Fielding School of Public Health at the University of California, Los Angeles.

The study also found that U.S.-born African American and Hispanic mothers, as well as foreign-born black and Central/South American mothers, were more likely to have children with a type of autism that included severe emotional outbursts and expressive language impairment, compared to U.S.-born white mothers.

The study is published in the July print issue of Pediatrics.

Although this study found an association between a mother's birthplace or race and the development of an autism spectrum disorder, the study doesn't show that these factors cause autism.

Autism spectrum disorders describe a range of developmental disabilities that can cause social, communication and behavioral difficulties. About 1 in 68 U.S. children have an autism spectrum disorder, the U.S. Centers for Disease Control and Prevention (CDC) estimates.

The exact cause of autism is unknown, but a number of risk factors have been found, including genetic risk factors, being born to older parents and having a sibling with the disorder, according to the CDC.

Previous studies have found autism spectrum disorders are most common among white children, Ritz noted.

In her study, Ritz wanted to look at the influence of the mother's race, ethnicity and birthplace. She and her colleagues reviewed the records of 7,540 children with autism who were born in Los Angeles County during the years 1998 to 2009 and given an autism diagnosis at ages 3 to 5 years. The researchers adjusted for other factors such as maternal age and education.

Compared to white children of U.S.-born mothers, the risk of autism was 76 percent higher for children of foreign-born black mothers, she said.

Mothers born in Vietnam, the Philippines, Central and South America also were at higher risk of having a baby with autism.

The researchers also found a small subgroup of 806 children who had both an autism spectrum disorder and mental retardation. For this group, having a foreign-born mother further increased the risk of the disorder. In fact, the risk was doubled for children born to foreign-born black mothers or those from the Philippines or Vietnam compared to U.S.-born white mothers, the study reported.

Additionally, for a specific type of the disorder that included severe emotional outbursts and impaired expressive language, U.S.-born Hispanic and black mothers, and foreign-born black and Central/South American mothers were more likely to have a child with this type of autism than U.S.-born white mothers.

The study wasn't designed to tease out the reasons behind this association, but Ritz has some theories. She believes that it's possible that "a child is more likely to develop an ASD if the mother emigrated from a country which had political unrest or wars in the recent past."

Even if those events were 20 or 30 years ago, it could still have an effect, she said. The mother giving birth may have witnessed atrocities of war or other trauma as a child, perhaps programming her to react to stress in a certain way. These mothers may react to stress in a certain way when pregnant, and that could affect the baby's ''brain wiring," she speculated.

As for whether these mothers can obtain ideal care and a prompt diagnosis for an autism spectrum disorder, Ritz cannot say, as it was outside the scope of the study. However, the average age at diagnosis for all the youngsters in this study was in the child's third year, according to the study.

"It's an interesting study to have done. It's a first step to begin to try in a more detailed fashion to identify other causes of autism," said Dr. Trevor Resnick, chief of neurology at Miami Children's Hospital. Resnick was not involved in the research, but reviewed the study's findings.

Pinning down the cause of autism spectrum disorders is complex, he said. Experts know genetic, metabolic and structural factors affect risk. "We know there is not one cause, there are multiple causes," he said.

There may even be multiple causes within one child, Resnick noted.

What the new study seems to identify is the risk of autism in different ethnic groups, he said. But the common factor is the immigrant status, not the ethnicity itself, he noted.

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Minority children with autism more likely to have a developmental regression - One third regress!

A study shows that one third of minority children with autism have a developmental regression! But why? JR

Minority children with autism are more likely to have lost critical developmental skills, such as walking or talking, than are white children, according to a new study.

The phenomenon, called developmental regression, occurs when children have reached milestones such as saying words and walking, and then those skills suddenly vanish. The new research found that the odds of developmental regression were twice as high for black children and 1.5 times higher for Hispanic children than they were for white youngsters.

It's estimated that one-third of children with autism go through developmental regression, said lead researcher Dr. Adiaha Spinks-Franklin, of Baylor College of Medicine and Texas Children's Hospital in Houston.

"They learn to babble or talk, then stop. They learn to play patty-cake, then stop," said Spinks-Franklin.

This appears to be the first study to show racial disparities in rates of developmental regression. And for now, the cause is unclear, Spinks-Franklin said.

No one knows why regression happens at all, said Dr. Dan Coury, medical director for the Autism Speaks Autism Treatment Network.

"But it does make us wonder if it might be a different type of autism, with different causes," Coury said.

Autism is a developmental disorder that -- to widely varying degrees -- impairs a child's ability to communicate and interact socially. Some kids have relatively mild problems relating to other people; others speak very little or not at all, and focus obsessively on only a couple of interests and engage in repetitive behaviors.

Researchers have managed to find a few hundred genes related to autism risk, and experts believe the disorder arises from a complex mix of genes and environmental exposures -- though it's not yet clear what those exposures are.

Coury said future studies could look into whether genes play a role in minority children's higher rate of regression. Another question, he said, is whether their parents might have had different environmental exposures before and during pregnancy.

Researching those possibilities, Coury noted, could also give clues to the causes of autism in general.

The current findings are based on 1,353 preschool children included in the Autism Speaks Autism Treatment Network (ATN) database. The children were from 17 different areas across the United States and Canada.

Based on parents' reports, 27 percent of the children had reached certain early milestones, such as saying words or making eye contact, then lost those skills.

Black and Hispanic parents were more likely to report lost skills, even when the researchers took into account for parents' education levels, whether they had insurance, and whether their child had already been diagnosed with autism before coming to the ATN.

It's already known there are other racial disparities in autism, Spinks-Franklin pointed out. Black and Hispanic children are typically diagnosed later than white children are -- whether they have developmental regression or not, Coury noted.

One reason, he said, is that minority families may have less access to health care.

According to the U.S. Centers for Disease Control and Prevention, children should be screened for developmental delays during routine "well-child" visits -- at the ages of 9 months, 18 months, and 24 or 30 months.

Autism can be difficult to diagnose, the CDC says, but can sometimes be detected by the age of 18 months. By age 2, a diagnosis from an experienced professional can be considered "very reliable," the agency says. Yet many children don't receive a definite diagnosis until school age.

That's something experts want to change. "The earlier we intervene, the better the outcomes," Coury said. "And that's pretty universal, whether children have regression or not."

Early intervention therapies start by age 3, and focus on building kids' language, movement and social skills.

Spinks-Franklin agreed that timely diagnosis is critical. "It's important for parents to be aware of the signs of autism," she said.

If you're worried about possible delays in your child's development, talk to your doctor, Spinks-Franklin advised. And if your child seems to have lost a skill, she added, that's a "red flag."

"In that case, don't hesitate to talk to your doctor," Spinks-Franklin said.

The findings from this study were presented on Tuesday at the Pediatric Academic Societies annual meeting in Vancouver. Findings presented at meetings should be considered preliminary until they've been published in a peer-reviewed journal.

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Autism regression is more common in Hispanic and Black children, study claims

A study claims that autism regresses more commonly in Hispanic and Black children than children of other races.

Autism spectrum disorders (ASDs) are a set of developmental disorders characterized by varying levels of social and communication problems. In a new study, researchers examined autistic children's likelihood of developmental regression, which occurs when children start to lose certain skills, such as talking, making eye contact and walking on schedule. The researchers found that black and Hispanic children appear to have a greater risk of regression than white children.

"Lost skills are very difficult to recover," said lead author Adiaha I. A. Spinks-Franklin, MD, MPH, FAAP, assistant professor of pediatrics at Baylor College of Medicine in Houston and associate director of the Developmental-Behavioral Pediatric Fellowship at Texas Children's Hospital. "Evidence suggests that African-American and Hispanic children are often diagnosed with autism at later ages than white children and have less access to services. Our research shows there is one more important factor that contributes to the developmental outcomes of African-American and Hispanic children with autism."

For this study, the researchers examined data on 1,353 autistic children who were a part of the Autism Speaks Autism Treatment Network database from March 2008 to December 2011. The data on the preschool children's demographics and medical information were collected at one of 17 locations throughout the U.S. and Canada.

The researchers found that 27 percent of the children went through developmental regression, which was reported by their parents. Based on these reports, the researchers calculated that black children were two times more likely to regress than white children. Hispanic children were 1.5 times more likely to regress than white children. The researchers found that these links exist even after accounting for the education levels of the children's primary caretaker and the children's insurance status

"We want parents to know that if they have any concerns about behavior or development patterns in their children - whether the concern is a loss of skills or some other type of concern - their child should be evaluated by a physician as soon as possible," said study co-author Jennifer B. Swanson, MD, FAAP, first-year developmental-behavioral pediatric fellow at Baylor College of Medicine, reported in the press release.

The study, "Racial Differences in Developmental Regression in Children with Autism Spectrum Disorders," was presented at the Pediatric Academic Societies (PAS) yearly meeting in Vancouver, British Columbia, Canada.

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What increases risk for sleep apnea?

This article discusses 8 things and behaviors that can increase a person's risk for sleep apnea.

It used to be that if someone told you you snored, you shrugged it off as more of an annoyance to them than anything telling about your own health and wellbeing.

Today, we have a greater understanding of at least one potential risk of being a frequent snorer: You could have sleep apnea, a potentially harmful sleep disorder during which people stop breathing, sometimes hundreds of times a night.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea, and occurs when the muscles in the back of the throat collapse, causing the opening through which air passes to disappear. (Watch this video for an in-depth explanation of what happens during OSA.)

But certain people are more likely to experience this interruption of breathing than others. We asked Dr. Matthew Mingrone, lead physician for EOS Sleep Centers in California specializing in sleep apnea and snoring issues, to help explain why.

Obesity
Likely the most indicative risk factor is carrying too much extra weight. Obese adults are seven times more likely to develop OSA than their normal-weight peers, according to WebMD. OSA is essentially a blockage of the upper airway, says Mingrone. Part of the tissue running from the nose to the voicebox collapses, cutting off the passage of oxygen. Excess weight adds to the pressure on tube, he says, making the diameter of the opening even smaller than it already is.

Neck Circumference

Obese people aren't the only demographic with larger-than-average necks. Consider the muscular build of professional athletes, for example, who aren't obese but thanks to muscle development are larger than us mere mortals.

Men with a neck circumference greater than 17 inches and women over 15 inches have a higher risk of OSA, WebMD reported.

Age
People of any age can develop sleep apnea, but the condition is more common the older you get, according to the National Heart Lung and Blood Institute. "As we get older, we lose tone and elasticity as part of the normal aging process," says Mingrone. With that natural softening of the tissue in the throat, there's higher likelihood of collapse, he says.

Family History
It's not that you have a genetic predisposition to developing sleep apnea, says Mingrone, like a specific type of cancer that may run in families. Instead, it's likely that you've inherited certain aspects of your physical makeup that increase sleep apnea risk, he says. If Mom's being treated for sleep apnea and you've inherited her narrow jaw, you may have a similar doctor's visit in your future.

Alcohol Use

Because it's a muscle relaxant, alcohol too close to bedtime can lead to episodes of apnea, says Mingrone, even in someone who doesn't have OSA. And in those with the disorder, alcohol can lengthen the duration of apnea episodes, according to the National Institute on Alcohol Abuse and Alcoholism.

Race
Studies show that both sleep apnea risk and sleep apnea severity vary by race. It may be due to anatomical differences in the airways of different ethnic groups, according to Mingrone.

Smoking

Current smokers are 2.5 times more likely to have OSA than smokers and nonsmokers combined, according to a 2001 study. "Smoking most airway tissue swell because it's an irritant," says Mingrone. Swelling in the nose and the throat further reduces the space for air to flow through.

Gender
Middle-aged men are twice as likely to have OSA than women of the same age, according to the American Lung Association. Mingrone says in his practice, about 15 to 20 percent of patients are female. The variance may be due again to anatomical differences, especially since men are simply bigger than women more often than not.

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Study claims insufficient sleep is more likely in African Americans

A study shows that African Americans are more likely than whites to get insufficient sleep.

Black Americans are more likely than whites to get too little sleep and this disparity is greatest among people in professional occupations, a new study shows.

Lack of sleep has been linked with increased risk of health problems, such as obesity, high blood pressure, diabetes, heart disease and even death.

For the study, researchers analyzed data collected from nearly 137,000 American adults between 2004 and 2011, and found that 30 percent of them were short sleepers (getting less than seven hours of sleep a night), 31 percent were optimal sleepers (getting about seven hours of sleep a night), and 39 percent were long sleepers (getting more than seven hours of sleep a night).

Further analysis revealed that 37 percent of black participants were short sleepers, compared with 28 percent of white participants. Among people in professional or management positions, blacks were much more likely than whites to be short sleepers (42 percent versus 26 percent), according to the Harvard School of Public Health researchers.

Blacks working in support services or as laborers were also more likely than whites to be short sleepers, 37 percent versus 26 percent and 35 percent versus 32 percent, respectively. The only job sectors in which blacks and whites had similar rates of short sleep were the retail and food industries.

The findings were published online Sept. 9 in the American Journal of Epidemiology.

"With increasing numbers of blacks entering professional and management roles in numerous industries, it is important to investigate and address the social factors contributing to the short sleep disparities in blacks compared with whites in general, and particularly in professional settings," study author Chandra Jackson, a postdoctoral research fellow in the department of nutrition, said in a Harvard news release.

Possible sleep-disrupting factors that affect blacks more than whites include: job stress; workplace discrimination or harassment that can increase job stress; limited control over job demands or prestige; long work hours; stress at home; and limited access to professional and social networks that provide emotional or financial support.

In addition, blacks are more likely than whites to do shift work and are also more likely to live in city neighborhoods with high noise levels at night, the researchers noted.

And, the study authors pointed out, it's also possible that a high work ethic among blacks -- a strong desire to succeed against all odds -- could lead to stress, disrupted sleep and harmful health effects.

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Study: Sleep Apnea Symptoms Vary by Race

This new study adds to our knowledge of the effect of race/ethnicity on sleep disorders and the PERCEPTION of sleep problems. 

We have known for some time that certain groups are more susceptible. 

Sleep apnea is another possible element of the study of the prevalence of hypertension and vascular disorders in certain ethnic groups. - JR

From the Huffington Post.....

"Risk factors for obstructive sleep apnea -- the sleep disorder in which breathing repeatedly stops and starts -- run the gamut, from smoking and high blood pressure, to the most common, high body mass index (BMI). But a recent study by researchers at Wayne State University School of Medicine reveals that even with BMI accounted for, one key risk factor remains -- race.

In the study of 512 patients observed at the Detroit Receiving Hospital Sleep Disorders Center between July 1996 and February 1999, 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. No difference was found between African-American and white women, however.

Lead researcher, James Rowley, PhD, professor of medicine at Wayne State Medical Director of the sleep disorders center, says that the mechanism for a racial difference in sleep apnea severity is unclear, but potential mechanisms include anatomic differences that affect the way the upper airway open and close, as well as differences in the neurochemical control of breathing.

According to the Mayo Clinic, there are two main types of sleep apnea:

Obstructive sleep apnea, the more common form that occurs when throat muscles relax

Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing

Rowley's research isn't the first to identify differences in how race affects the quality of sleep.

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 blacks and Asians don’t sleep as much as whites do, and another study showing thatforeign-born Americans are less likely to report having sleep problems than those born in the U.S.

Unlike Rowley's study, however, the authors of last year's research surmise that the majority of the differences in sleep patterns between races can be chalked up to environmental or even geographical factors — rather than genes or physical characteristics like variations in facial structure that could interfere with breathing and sleep, TIME's Alice Park noted.

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Link Found Between Daytime Sleepiness and Vitamin D

A study shows a link between daytime sleepiness and vitamin D intake. Additionally, race plays a factor.

A new study suggests that there is a significant correlation between excessive daytime sleepiness and vitamin D, and race plays an important factor.

Results show that in patients with normal vitamin D levels, progressively higher levels of daytime sleepiness were correlated inversely with progressively lower levels of vitamin D. Among patients with vitamin D deficiency, sleepiness and vitamin D levels were associated only among black patients. Surprisingly, this correlation was observed in a direct relationship, with higher vitamin D levels associated with a higher level of sleepiness among black patients.

"While we found a significant correlation between vitamin D and sleepiness, the relationship appears to be more complex than we had originally thought," said David McCarty, MD, the study's principal investigator. "It's important to now do a follow-up study and look deeper into this correlation."

The study, appearing online in the Dec. 15 issue of the Journal of Clinical Sleep Medicine, involved a consecutive series of 81 sleep clinic patients who complained of sleep problems and nonspecific pain. All patients eventually were diagnosed with a sleep disorder, which in the majority of cases was obstructive sleep apnea. Vitamin D level was measured by blood sampling, and sleepiness was determined using the Epworth Sleepiness Scale.

According to the authors, this is the first study to demonstrate a significant relationship between sleepiness and vitamin D. They noted that it is logical for race to affect this relationship because increased skin pigmentation is an established risk factor for low vitamin D.

The study was not designed to examine causality. However, the authors' previous and current research suggests that suboptimal levels of vitamin D may cause or contribute to excessive daytime sleepiness, either directly or by means of chronic pain.

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