Abstract P442: Secondhand Smoking Associated With Sleep Apnea Risk Score

Abstract

Introduction: Approximately 18 million people have obstructive sleep apnea. While many people experience occasional nights of insufficient sleep, chronic sleep disorders are more serious and increase the risk of injury, morbidity, and mortality. While the association between smoking and sleep problems is well established, the relationship between secondhand smoke on sleep disordered breathing risk is less clear. Hypothesis: Sleep apnea risk increases with the presence of a smoker in the household. Methods: Data from N=9,232 adults were leveraged from the NHANES 2017-March 2020 dataset. The outcome/dependent variable of interest was sleep apnea risk score based on modified STOP-BANG criteria combined, as well as the presence/absence of snoring, tiredness, gasping, high blood pressure, BMI > 35, age > 50, and male gender. The exposure/independent variable was smoking status categorized as no smoker at home (reference) compared to whether there was an outside only smoker or someone who smoked indoors. Linear models estimated the association between smoking and overall risk, while logistic regression models estimated the association between smoking and individual risk factors. Results: Compared to no-smoking households, those with only outdoor smokers had a 0.187 point greater sleep apnea risk score ( p = 0.008), while those with an indoor smoker had a 0.211 point greater sleep apnea risk ( p = 0.018). Outdoor smoking was associated with greater likelihood of concurrent tiredness/sleepiness (OR 1.30, p = 0.014), gasping (OR 1.29, p = 0.024), and less likelihood of being over 50 (OR 0.52, p < 0.001). Indoor smoking was associated with greater snoring (OR 1.33, p = 0.027) and tiredness (OR 1.29, p = 0.013). Indoor/outdoor smoking was not associated with high blood pressure, BMI, or male gender. Conclusion: Having a smoker in the home (Indoor and outdoor) wasere associated with greater apnea risk score. Location of smoking varied in association with individual apnea symptoms, but not in any consistent way. Although studies have shown that smoking worsens sleep apnea risk, future work should explore whether smoking cessation can improve health in other family members as well.