Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study

The Interactions between Smoking and Sleep

“…Smokers also seem to present more severe OSAHS, at least in the majority of the studies [5,7,[80][81][82][83][84], compared to non-smokers. Numerous OSA indices were deteriorated in smokers including ODI, mean and minimum SaO2, total sleep time and sleep time ratio with SaO2 below 90%, mean apnoea duration, nocturnal hypoxia index and COHb levels [5,7,[80][81][82][83][84][85][86][87][88][89]. However, the relationship of AHI with smoking is not clear.…”

“…However, the relationship of AHI with smoking is not clear. Many studies concluded that AHI is deteriorated or affected in a dosedependent manner with smoking, even after adjusting for covariates [5,7,[80][81][82][83][84], while in other studies AHI seems not to be related with smoking [85][86][87][88][89][90][91][92]. As far as Epworth sleepiness scale (ESS), the majority of the studies concluded that it is worse in smokers [80,82,85,87], although there were also a few notable exceptions in this topic [7,91].…”

“…Evidence also exists about diminished sleep continuity and increased wake time after sleep onset [108]. As far as sleep stages, it seems that N3 stage or slow wave sleep is decreased in smokers, while N1 and N2 stages are increased, changes that seem to be dose dependent, as they are more evident to heavy smokers compared to mild smokers, or to current smokers compared to former smokers [5,81,86,109]. In another study, smokers presented shorter sleep period time, longer sleep latency and consequently higher REM sleep density with no differences regarding parameters of spectral analysis of the sleep electroencephalogram as well as in the sleep efficiency measured by PSG [26].…”