Exploratory analysis of obstructive sleep apnea (OSA) risk in survivors of intracerebral hemorrhage (ICH) enrolled in the REDUCE trial.

There are well-described racial and ethnic disparities in ICH. OSA is a recently identified risk factor for ICH. We analyzed data from ICH survivors in the ongoing REDUCE trial to determine whether race/ethnicity was associated with higher versus lower risk of OSA.

The Berlin questionnaire (BQ), a 10-item questionnaire to assess OSA risk, is validated in stroke survivors. Our analysis was conducted on data from 59 subjects enrolled across all five sites of the REDUCE trial, a pragmatic, randomized, open-label trial comparing the effect of a spironolactone-containing antihypertensive regimen versus a standard regimen in survivors of ICH. Subjects completed the BQ at the time of enrollment and were stratified as high versus low risk for OSA using standard definitions. Independent samples t-tests, two-sample z-tests for proportions, and chi-squared analyses were used to assess differences between high and low risk groups. 

Of the 59 subjects, 40.7% were female, 35.6% were Black, 11.9% identified as Hispanic, the average age was 62.5 ± 12.1, and the median number of days post-ICH was 116. High risk scores were assigned to 28 (47.5%) subjects; 31 (52.5%) were low risk. The two groups were balanced for sex and BMI. The average age of the low-risk group was higher (66.4 vs. 58.2 in high risk, p = 0.008). There was no association between race and OSA risk (p = 0.313). Subjects identifying as Hispanic were significantly more likely to be at high risk for OSA than subjects identifying as non-Hispanic (85.7% versus 42.3%, p = 0.031).

Hispanic ICH survivors were more likely to be at high risk for OSA than non-Hispanic ICH survivors. This preliminary finding should be confirmed in a larger cohort.