Abstract
Background and Objectives: Studies have tried to establish a relationship between Obstructive Sleep Apnea syndrome (OSA) and smoking but data still remain controversial. We aimed: 1. To evaluate the relationship between smoking and OSA; 2. To explore potential differences according to gender, and 3. To analyze the prevalence of cardiovascular disease (CVD) co-morbidities according to gender and smoking status. Materials and Methods: This retrospective study included 3791 (70.6% males) adult patients who visited a Sleep Clinic. All participants underwent nocturnal polysomnography. Daytime somnolence and insomnia were assessed by using the Epworth Sleepiness Scale (ESS) and the Athens Insomnia Scale (AIS). Ever-smokers completed the Fagerstrom Test for Nicotine Dependence (FTND). Results: OSA was confirmed in 72.1% of participants with 62.2% suffering from moderate-to-severe disease. The number of cigarettes/day, Pack/Years, and FTND were significantly higher in patients with more severe OSA. The prevalence of current smokers was higher in those without OSA or with mild disease, whereas the prevalence of former smokers was higher in moderate and severe OSA. In univariate analysis, current smokers were found to be 1.2 times more likely to have OSA compared with never and former smokers combined and former smokers 1.49 times more likely compared with never smokers. In the multiple regression analysis, after adjusting for BMI, gender, age and number of alcoholic drinks per week, smoking was not found to be significantly associated with OSA. In gender stratified multivariate analyses, no significant associations were observed. CVD co-morbidities were more frequent in more severe OSA. Hypertension, coronary disease and diabetes were more prevalent in former smokers with AHI ≥ 15, compared with current smokers, especially in men. Conclusions: Even if an independent effect of smoking on OSA was not found, the number of cigarettes/day, Pack/Years, and FTND were higher in patients with more severe OSA with more prevalent CVD co-morbidities.
Highlights
Obstructive sleep apnea syndrome (OSA) is the most common sleep-related breathing disorder characterized by snoring, repeated episodes of airflow cessation, hypoxemia during sleep, and daytime hypersomnolence [1,2]
Hypertension, coronary disease and diabetes were more prevalent in former smokers with apnea hypopnea index (AHI) ≥ 15, compared with current smokers, especially in men
We found that the number of cigarettes/day, the pack years (P/Ys) and nicotine dependence were significantly higher in patients with more severe OSA
Summary
Obstructive sleep apnea syndrome (OSA) is the most common sleep-related breathing disorder characterized by snoring, repeated episodes of airflow cessation, hypoxemia during sleep, and daytime hypersomnolence [1,2]. 33% in men and from 6% to 19% in women, respectively [3]. Women may be vulnerable to OSA during life events like pregnancy and menopause as reproductive hormone levels change [4,5]. Females appear to have a different OSA clinical presentation compared with males with lower apnea hypopnea index (AHI). Women report less snoring and episodes of respiratory events than men, while insomnia, fatigue, headaches and mood changes are reported more frequently. As a consequence of this different clinical profile, OSA may be under-diagnosed in females [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
