Social determinants of sleep apnea in Canada: A cross-sectional study exploring the intersection between immigrants’ length of residence and visible minority status

This study aims to explore the intersection between immigrants' length of residence and visible minority status, examining how these factors influence the likelihood of obstructive sleep apnea (OSA) reported by a health professional. Utilizing data from the 2015–16 Canadian Community Health Survey and employing logistic regression analyses, we compare the prevalence of OSA reported by a health professional among distinct groups: white native-born, visible minority native-born, white recent immigrants, visible minority recent immigrants, white established immigrants, and visible minority established immigrants. At the unadjusted level, our findings indicate that visible minority native-born (cOR=0.57, p < 0.001) and recent immigrants (cOR=0.34, p < 0.001) are less likely to receive a sleep apnea diagnosis compared to white native-born individuals. However, when adjusting for demographic variables, particularly the age of respondents, the robustness of the significance diminishes for visible minority native-born (aOR=1.07, p > 0.05), while becoming significant for white established immigrants (aOR=0.79, p < 0.01). Despite remaining largely consistent after accounting for socioeconomic, behavioural, and health characteristics, the significance for visible minority recent immigrants (aOR=0.69, p > 0.05) and white established immigrants (aOR=0.82, p < 0.05) is substantially explained when considering BMI. Based on these findings, we discuss implications for policymakers and suggest avenues for future research.