Relationship Between Sleep Apnea Symptoms and Metabolic Syndrome Among Racially and Ethnically Diverse Adolescents and Young Adults in the United States

Abstract

Background: Metabolic Syndrome (MetSyn) and Sleep Apnea (SA) contribute to long-term cardiometabolic risks among adolescents and young adults (AYAs). Emerging research suggests that certain race and ethnic groups experience disproportionate burdens of MetSyn and SA. Therefore, this study investigated the association of SA symptoms and MetSyn among AYAs in the United States and reported on associated racial and ethnic disparities. Methods: National Health and Nutrition Examination Survey data from 2015 to 2020 (N = 2539) were analyzed. Sleep disorders, medical conditions, and anthropometric data were collected via interviews and physical examinations. MetSyn was defined based on the International Diabetes Federation criteria. Bivariate associations were assessed by univariate logistic regression models and age-adjusted associations by multivariable logistic regression models. Stratified analyses examined race/ethnic group differences in the associations. Results: Nearly 50% of the sample (mean age 20.6 years, 48.9% female, 55.3% non-Hispanic White) reported SA symptoms and 4.6% had MetSyn. After adjustment, central obesity was a consistent predictor of overall sleep apnea symptoms [aOR = 1.58; 95% CI: 1.29, 1.94], snoring [aOR = 2.10; 95% CI:1.70, 2.60], breath cessation [aOR = 2.59; 95% CI: 1.42, 4.73] and daytime sleepiness [aOR = 1.34; 95% CI: 1.06, 1.68]. Non-Hispanic Black individuals with MetSyn had significantly higher odds of sleep apnea symptoms [aOR = 4.19; 95% CI: 1.40, 12.51], snoring [aOR = 6.64; 95% CI: 2.10, 21.0], and breath cessation [aOR = 8.64; 95% CI: 3.12, 23.93] versus participants of other races and ethnicities without MetSyn. Conclusion: This study highlights the significant relationships between parameters of MetSyn and SA symptoms, and the disproportionately higher odds of SA symptoms among certain race/ethnic groups with a heavy burden of metabolic disorders.