{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:02:49Z","timestamp":1790622169907,"version":"4.1.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is common in Pacific Islanders; however, its pathophysiological mechanisms are unknown. We compared OSA severity and endotypes between Pacific Islanders and Caucasians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Retrospective polysomnography data were analyzed using inverse probability of treatment weighting (IPTW) to balance age, sex, and BMI. Sleep stage endotypes were derived using validated non-invasive methods. Generalized linear models (GLMs) were used to estimate population-average differences and rank-based tests used as sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty two Pacific Islanders vs 62 Caucasians were included. There was no difference in apnea\u2013hypopnea index between groups (adjusted mean difference 2.8 events\/h, 95% CI [\u22129.0 to 14.5]; p\u2009=\u2009.64). Pacific Islanders had higher mean apnea length (5.6\u00a0s, [2.1 to 8.9]; p\u2009=\u2009.001), oxygen desaturation index \u22653% (12.5 events\/h, [4.3 to 20.7]; p\u2009=\u2009.003), average desaturation during events (2.4%, [1.1 to 4.0]; p\u2009&amp;lt;\u2009.001), time with SpO\u2082\u2009&amp;lt;\u200990% (12.3\u00a0min, [2.5 to 22.0]; p\u2009=\u2009.016), hypoxic burden (67.4%\u00a0min\/h, [21.7 to 113.2]; p\u2009=\u2009.012) and supine proportion (20.8% [6.6 to 34.9], pGLM\u2009=\u20090.005). They also had higher rapid eye movement (REM) arousal threshold (14.4%Veupnea, [1.3 to 27.5]; p\u2009=\u2009.033), lower REM Vpassive (\u221213.3%Veupnea, [\u221223.8 to \u22122.9]; p\u2009=\u2009.015), and higher non-rapid eye movement (NREM) loop gain (0.04, [0.00 to 0.09]; p\u2009=\u2009.047), except for REM arousal threshold endotype differences were absent after supine adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Pacific Islanders, OSA is characterized by longer apnea and increased hypoxic burden, with distinct endotypes. Strategies targeting endotypes and hypoxic burden may improve treatment and mitigate cardiometabolic consequences in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag245","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:48:33Z","timestamp":1789127313000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypoxic burden from obstructive sleep apnea is increased in Pacific Islanders with distinct pathophysiological traits"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1359-4616","authenticated-orcid":false,"given":"Fahimeh","family":"Faqihi","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research , Sydney ,","place":["Australia"]},{"name":"Westmead Clinical School, Faculty of Medicine and Health, University of Sydney , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Naidoo","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Westmead Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Westmead Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Johnson","sequence":"additional","affiliation":[{"name":"Westmead Sleep Investigation Research Centre, Westmead Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Lambert","sequence":"additional","affiliation":[{"name":"Westmead Sleep Investigation Research Centre, Westmead Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9041-3655","authenticated-orcid":false,"given":"Shane A","family":"Landry","sequence":"additional","affiliation":[{"name":"Department of Physiology, Biomedical Discovery Institute, Monash University , Melbourne ,","place":["Australia"]},{"name":"School of Psychological Sciences, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8209-1601","authenticated-orcid":false,"given":"Denise M","family":"O\u2019Driscoll","sequence":"additional","affiliation":[{"name":"Department of Sleep & Respiratory Medicine, Eastern Health and Eastern Health Clinical School, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9383-1644","authenticated-orcid":false,"given":"Bradley A","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Physiology, Biomedical Discovery Institute, Monash University , Melbourne ,","place":["Australia"]},{"name":"School of Psychological Sciences, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1605-8843","authenticated-orcid":false,"given":"John R","family":"Wheatley","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Westmead Hospital , Sydney ,","place":["Australia"]},{"name":"Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research , Sydney ,","place":["Australia"]},{"name":"Westmead Clinical School, Faculty of Medicine and Health, University of Sydney , Sydney ,","place":["Australia"]},{"name":"Westmead Sleep Investigation Research Centre, Westmead Hospital , Sydney 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