Abstract Introduction Sleep-disordered breathing (SDB) affects up to 17% of children and is associated with subjective sleepiness and neurobehavioral impairments, both of which appear to be more pronounced in Black children compared to White peers. However, objective sleepiness measured by the Multiple Sleep Latency Test (MSLT) in pediatric SDB remains understudied. Therefore, we aimed to compare objective sleepiness in Black and White children with and without SDB. We hypothesized that Black children with and without SDB would have greater objective sleepiness than White children. Methods Cross-sectional study of typically developing Black and White children aged 8-12 years with SDB clinically referred to the sleep lab, and matched healthy controls recruited for research purposes. Participants underwent overnight polysomnography and MSLT. Multiple linear regression was used to examine MSLT mean sleep latency(objective sleepiness, lower values indicating greater sleepiness), adjusting for study arm, race, obstructive apnea hypopnea index (OAHI), and age, to account for developmental differences in sleep latency. Results As shown in Table 1, 174 children (mean age 9.88±1.38 years), two-thirds of whom were Black (66.7%) were recruited. While study groups were balanced on age, the SDB group had a significantly higher proportion of Black children compared to controls. After controlling for age, race and study arm together explained 23% of the variance in objective sleepiness (F(6, 167) = 8.43, p 0.001). Black children demonstrated significantly greater objective sleepiness compared to White children (β = -19.13, p = 0.011). Higher OAHI was associated with increased objective sleepiness (β = -0.22, p 0.001). Conversely, greater arousal index was linked to reduced objective sleepiness (β = 1.54, p = 0.001). SDB status alone was not associated with objective sleepiness (β = -2.18, p = 0.787). The interaction between race and SDB was not statistically significant (β = -12.79, p = 0.257). Age was inversely associated with objective sleepiness (β = -5.21, p = 0.018). The racial disparity in objective sleepiness persisted across both control and SDB groups. Conclusions Compared to White children, Black children exhibited significantly greater objective sleepiness, independent of SDB status. Greater SDB severity and older age were associated with increased objective sleepiness, while greater sleep fragmentation was associated with reduced daytime sleepiness. The persistent difference in objective sleepiness by child race across study arms suggests that SDB alone may not contribute to differences in daytime sleepiness. These findings underscore the importance of investigating socioecological factors beyond SDB that may contribute to racial disparities in pediatric sleep. This abstract is funded by: NHLBI R01HL152454
Tapia et al. (Fri,) studied this question.