A common test used to diagnose obstructive sleep apnea (OSA) may miss the condition in Black patients, potentially affecting important treatment decisions.
Sleep studies often use pulse oximeters — small devices that measure blood oxygen levels — to help determine the severity of sleep apnea.
In the new study, oxygen-based scoring counted roughly 20 percent fewer breathing events in Black participants than in white participants. But heart-rate-based scoring showed no comparable racial difference.
The findings have “potential implications for diagnosis and severity classification,” said first author Ali Azarbarzin, of the Division of Sleep and Circadian Disorders at Mass General Brigham in Boston.
Earlier research showed pulse oximeters may be less accurate on darker skin. The study can’t prove the device is the cause, though.
The researchers say a normal or borderline result in Black patients should be read carefully when symptoms or other conditions strongly suggest sleep apnea. That means loud snoring, gasping at night, daytime exhaustion, or conditions like 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 was published Nov. 4 in the American Journal of Respiratory and Critical Care Medicine.
Research shows that Black adults experience higher rates of hypertension, stroke, heart failure, and type 2 diabetes, which are all conditions strongly associated with untreated obstructive sleep apnea. Delayed or missed diagnosis of OSA may contribute to worsening cardiovascular outcomes.
For clinicians, earlier identification of the sleep disorder could potentially help improve Black patients’ quality of life, daytime functioning, and chronic disease management.
The apnea-hypopnea index (AHI) is a diagnostic measurement that tracks the average number of times a patient stops breathing and has shallow breathing events per hour. It is the standard diagnostic tool to identify obstructive sleep apnea.
Emerging evidence suggests it may not fully capture the burden of disease in all patient populations, including Black communities.
Oxygen desaturation, total hypoxic burden, symptom severity, cardiovascular risk factors, and patient-reported outcomes may provide additional context beyond AHI results.
Reducing sleep apnea disparities starts with asking patients more detailed questions about sleep and maintaining a lower threshold for evaluation when symptoms are present.
Practical approaches providers can incorporate into clinical practice include:
More information
The Mayo Clinic has more on sleep apnea.
SOURCE: HealthDay TV, Nov. 5, 2026
By subscribing, you consent to receive emails from BlackDoctor.pro You may unsubscribe at any time. Privacy Policy & Terms of Service.
Are you a healthcare professional? Register with us today!
