Association between smoking and obstructive sleep apnea based on the STOP-Bang index

Abstract

Smoking is a risk factor for respiratory diseases, and it worsens sleep quality due to nicotine stimulation and sudden nicotine withdrawal during sleep. This can increase the severity of OSA through alterations upper airway inflammation and neuromuscular function, arousal mechanisms, and sleep architecture. Therefore, it may lead to sleep-disrupted breathing, particularly obstructive sleep apnea (OSA). Herein, this study aims to research the association between smoking and OSA through the STOP-Bang index. In this study, total sample of 3442 participants (1465 men and 1977 women) were analyzed. We used data from the Korea National Health and Nutrition Examination Survey in 2020 by classifying adults into current, ex-, and non-smokers. A multiple logistic regression analysis was used to investigate the association between smoking and OSA. Furthermore, multinomial regression analysis was used to investigate the effect of smoking cessation. For males, compared to the non-smokers, the odds ratios (OR) for the OSA were significantly higher in the ex-smokers (OR: 1.53, 95% confidence interval(CI) 1.01–2.32) and current smokers (OR: 1.79, 95% CI 1.10–2.89). In females, higher ORs were observed for OSA risk, similar to the non-smokers, smoking cessation, and pack-years. Among men, OSA was significantly associated with a moderate risk for ex-smokers (OR: 1.61, 95% CI 1.05–2.48) and a severe risk for current smokers (OR: 1.88, 95% CI 1.07–3.29). This study observed that smoking might contribute to OSA risk among adults. Smoking cessation can help to manage sleep quality properly.

Exploring the Relationship Between Smoking and Poor Sleep Quality: A Cross-Sectional Study Using NHANES

“…This large, nationally representative cross-sectional study found significant associations between smoking and various sleep outcomes, including insufficient sleep duration, sleep problems, snoring, and snorting or stop breathing during sleep. Doseresponse analyses revealed that the odds of these sleep outcomes increased with higher smoking frequency, consistent with previous studies that smokers would have an elevated prevalence of sleeping disorders (Cohrs et al, 2014;Jang et al, 2023;Liao et al, 2019). However, our study provides more solid evidence due to the large sample size and examination of dose-response relationships.…”

The positive impact of smoking on poor sleep quality is moderated by IGF1 levels in cerebrospinal fluid: a case-control study among Chinese adults

“…there are studies that support the possible interactions between smoking, sleep quality, and respiratory problems. For example, a study by Jang et al found that smoking was associated with an increased risk of obstructive sleep apnea (OSA), a common respiratory disorder that can lead to poor sleep quality (30).…”

Association between adherence to Life’s Simple 7 metrics and risk of obstructive sleep apnea among adults in the United States

“…Besides, the association between hypertension and OSA has been identi ed to be bidirectional, with elevated BP signi cantly increasing the incidence of OSA, and OSA also increasing the risk of hypertension, especially resistant hypertension [31]. While studies evaluating the relationship between smoking and OSA have yielded inconsistent results, a recent study conducted by Jang et al among 3,442 participants of the Korea National Health and Nutrition Examination Survey found a positive dose-dependent relationship between smoking and the risk of OSA, with smoking cessation helping to properly manage sleep quality [32]. As a comprehensive assessment of lifestyle habits, the LS7 metrics may be a superior risk assessment tool for predicting the risk of OSA.…”