Influence of smoking on sleep and disease severity in a population of obstructive sleep apnea patients

RATIONALE :Despite many studies,the question of whether and how smoking habits and sleep are related is only partially answered. OBJECTIVE :To analyse the effects of smoking on sleep architecture and on obstructive sleep apnea(OSA) symptoms,comorbidities and severity of disease. METHOD :We studied retrospectively 104 OSA patients with normal lung function,without diurnal hypercapnia,without other sleep disrupting diseases who underwent polisomnography(PSG) and compared different groups(active smokers-AS, former-smokers-FS and never-smokers-NS) regarding anthropometrical data,OSA symptoms,severity,comorbidities and sleep study parameters using SPSS. RESULTS : 32.69% AS, 30.76% FS and 36.53% NS.We found no differences regarding demographic data,OSA symptoms,comorbidities and sleep architecture between AS vs FS and AS vs NS.Analyzing FS vs NS we found that FS are sleepier(10.3±5.3 vs 7.4±4.4),with a higher latency of sleep(26.8±27.5 vs 14.1±12.5) but also with a higher percent of REM sleep(11.5±7.7 vs 8±6.5),p<0.05.Comparing ever-smokers(AS and FS) with NS we found that ever-smokers have a higher arousal index(29.2±25.2 vs 17±14.1,p=0.002),higher AHI(39±27.1 vs 24.5±22.1,p=0.004) and AHI with arousal(16.7±20.2 vs 5.4±7.4,p<0.001) and higher AI in non-REM supine(19.4±25.6 vs 9.2±17.9,p=0.021) despite no difference regarding demographics,BMI and ENT alterations.OSA severity (AHI, AHI with arousal, arousal index, nighttime SpO2) correlates well (r=0.5,p<0.001) with smoking severity(pack-year) but not with nicotine addiction(Fagerstrom). CONCLUSION : Despite literature findings, it seems that smoking has more influence on OSA severity rather than on sleep architecture in our studied population.