Smoking history and its relationship with comorbidities in patients with obstructive sleep apnea

Abstract

INTRODUCTION Current knowledge on the correlation between smoking and comorbidities associated with obstructive sleep apnea (OSA) is limited. This study evaluated the smoking history of OSA patients and analyzed the association between smoking and OSA comorbidities. METHODS Retrospective analysis was performed in newly diagnosed OSA patients in our hospital, a tertiary medical center, from January 2016 to December 2019. In all, 1021 patients were enrolled and divided into two groups, nonsmokers (n=796) and current/former smokers (n=225), in order to compare their clinical manifestations and polysomnographic results and to analyze the association between smoking and comorbidities. RESULTS Compared with the non-smokers, the current/former smokers had higher Epworth sleepiness scale (ESS) scores (9.3 ± 4.0 vs 8.5 ± 5.1; p<0.05), longer sleep latency (SL) [20.5 (12.3-39.3) vs 18.5 (10.0-34.0) minutes; p<0.05], and a lower nocturnal mean oxygen saturation (91.8 ± 3.6% vs 92.8 ± 3.4%; p<0.001). There was no significant difference in the apnea-hypopnea index (AHI) between the two groups. OSA patients with a history of smoking had significantly increased risk of hypertension (OR=2.09; 95% CI: 1.46-3.01), chronic obstructive pulmonary disease (COPD) (OR=9.80; 95% CI: 4.73-20.33), gastroesophageal reflux disease (GERD) (OR=1.97; 95% CI: 1.19-3.27), and chronic pharyngitis (OR=1.83; 95% CI: 1.32-2.54). CONCLUSIONS No significant association was found between previous smoking history and current OSA severity. OSA patients with a history of smoking had an increased risk of hypertension, COPD, GERD, and chronic pharyngitis.

Smoking and Obstructive Sleep Apnea: Is There An Association between These Cardiometabolic Risk Factors?—Gender Analysis

“…Our results are in line with the observations of Bielicki et al [6] that also showed that the proportion of non-smokers with OSA with HTN was higher than that of ever-smokers. Contrary to our findings, Shao et al found a significant increase of HTN risk in current/former smoking patients with OSA [45]. This variation could be related to the differences of the populations studied.…”

“…In a like matter, in another retrospective analysis, no significant differences in the AHI were found when comparing current/former smokers with non-smokers. However, current/former smokers presented lower nocturnal mean oxygen saturation [45]. Opposite to our findings, these three latter studies [6,44,45] reported higher daytime sleepiness (ESS) in smokers that was attributed to the combined effects of nicotine on sleep architecture, on the upper airway and possibly to nocturnal hypoxia.…”

Smoking Obstructive Sleep Apnea: Arguments for a Distinctive Phenotype and a Personalized Intervention

“…In terms of symptoms, the main difference was noticed in daytime sleepiness and the Epworth score. In agreement with previous research [29], the Epworth scores are directly related to the AHI.…”

Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

“…Our results showed that smoking was reported in 23.5% of our sample, but smoking was not associated with increased AHI severity category. Previous research has established that smoking can negatively affect certain physiological sleep parameters by increasing sleep latency and reducing nocturnal oxygen saturation [ 84 ]. This result was not consistent with findings of previous studies that smoking was related to OSA severity [ 85 , 86 ], but was in accordance with other negative findings [ 87 , 88 ].…”