Higher Prevalence of Smoking in Patients Diagnosed as Having Obstructive Sleep Apnea

Abstract

Nightly nicotine withdrawal as well as other respiratory and pulmonary effects of smoking may result in sleep-disordered breathing, especially obstructive sleep apnea (OSA). We hypothesize that there is higher prevalence of smoking in patients with OSA. We also hypothesize that smoking is an independent risk factor for OSA. The aim of this study is to determine whether there is a higher prevalence of smoking in patients with OSA compared with patients who do not have OSA. To investigate this, we randomly selected a group of 108 patients who were diagnosed as having OSA, defined by an apnea-hypopnea index (AHI) of greater than 10 events per hour. We compared their smoking history with another randomly selected group of 106 patients without OSA, defined by an AHI of less than five events per hour. The prevalence of smoking in patients with OSA was found to be 35%, whereas it was only 18% in patients without OSA. Logistic regression analyses were performed to investigate the effects of smoking while adjusting for age, gender, body mass index (BMI), and number of alcoholic drinks per week. While holding fixed the BMI, gender, age, and number of alcoholic drinks per week, current smokers were found to be 2.5 times more likely to have OSA than former smokers and nonsmokers combined (odds ratio = 2.5, CI 1.3-4.7, p = 0.0049), and 2.8 times more likely to have OSA than former smokers alone (odds ratio = 2.8, CI = 1.4-5.4, p = 0.0028). Adjusted for BMI, gender, age, and number of alcoholic drinks per week, former smokers were not more likely than never smokers to have OSA (odds ratio = 1.2, CI = 0.55-2.7, p = 0.64). We conclude that cigarette smoke may be an independent risk factor for OSA in this referral population.

Sleep Disordered Breathing in Patients with Acute Coronary Syndromes

“…Another explanation may be inflammatory changes and sympathetic neural hyperactivity associated with ACS, 33 which could lead to destabilization of ventilatory control, affecting upper airway patency as well as chest wall muscles. 34 Considering that smoking is a predisposing factor for OSAHS, 35 an apparent explanation for the observed decrease of AHI 6 months later is that 12 of 16 current smokers in our study stopped smoking, with most of them included in the group of the 22 with decreased AHI 6 months later. Smoking habit has well-described negative effects in the upper airway via several mechanisms (inflammation, influence of declining nicotine levels in sleep stability, smoking related diseases) and may predispose or increase underlying sleep disordered breathing, especially in vulnerable populations, such as those with coronary disease.…”

The Association between Symptoms of Obstructive Sleep Apnea Syndrome and School Performance

“…sigara içenlerde basit horlama ve orta-ağır derecede uykuda solunum bozukluğu-nun anlamlı derecede yüksek olduğunu saptamışlar-dır [20]. Başka bir çalışmada ise sigara içiciliğini OUA grubunda, OUA olmayanlara göre daha fazla olduğunu gösterilmiştir [21]. Bizim çalışmamızda tüm öğrenciler değerlendirildiğinde sigara içen-lerde, içmeyenlere göre OUAS semptomlarından horlama oranlarının daha yüksek olduğu izlendi.…”

Effect of smoking habits on sleep

“…These studies notwithstanding, the literature (5-21) only partially responds to the question of whether and how smoking habits and sleep are related. Moreover, only a few studies considered the former smoking condition (17,18,20,21) or the number of packyears smoked (17)(18)(19). The purpose of the present study was to evaluate the effect of smoking status (current, former and non-smoker) and pack-years on objective sleep parameters, especially on respiratory parameters.…”

“…These disturbances are attributed to the stimulating effect of nicotine (7,8) and increased occurrence of snoring (9)(10)(11)(12)(13), even among passive smokers (14)(15)(16). The use of objective sleep parameters is restricted to only a few published studies (17)(18)(19)(20)(21).…”