Smoking history and its relationship with comorbidities in patients with obstructive sleep apnea

Chuan Shao; Huan Qi; Qing Fang; Jinjing Tu; Qianjun Li; Ling Wang

doi:10.18332/tid/123429

Smoking history and its relationship with comorbidities in patients with obstructive sleep apnea

Tob Induc Dis. 2020 Jul 1:18:56. doi: 10.18332/tid/123429. eCollection 2020.

Authors

Chuan Shao^{1

2

3}, Huan Qi^{2

3}, Qing Fang¹, Jinjing Tu¹, Qianjun Li^{4

5}, Ling Wang^{2

3}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
² Department of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou, China.
³ Department of General Practice, The First Affiliated Hospital of Soochow University, Suzhou, China.
⁴ Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁵ Department of Pulmonary and Critical Care Medicine, Ningbo Yinzhou No. 2 Hospital, Ningbo, China.

Abstract

Introduction: Current knowledge on the correlation between smoking and comorbidities associated with obstructive sleep apnea (OSA) is limited. This study evaluated the smoking history of OSA patients and analyzed the association between smoking and OSA comorbidities.

Methods: Retrospective analysis was performed in newly diagnosed OSA patients in our hospital, a tertiary medical center, from January 2016 to December 2019. In all, 1021 patients were enrolled and divided into two groups, non-smokers (n=796) and current/former smokers (n=225), in order to compare their clinical manifestations and polysomnographic results and to analyze the association between smoking and comorbidities.

Results: Compared with the non-smokers, the current/former smokers had higher Epworth sleepiness scale (ESS) scores (9.3 ± 4.0 vs 8.5 ± 5.1; p<0.05), longer sleep latency (SL) [20.5 (12.3-39.3) vs 18.5 (10.0-34.0) minutes; p<0.05], and a lower nocturnal mean oxygen saturation (91.8 ± 3.6% vs 92.8 ± 3.4%; p<0.001). There was no significant difference in the apnea-hypopnea index (AHI) between the two groups. OSA patients with a history of smoking had significantly increased risk of hypertension (OR=2.09; 95% CI: 1.46- 3.01), chronic obstructive pulmonary disease (COPD) (OR=9.80; 95% CI: 4.73-20.33), gastroesophageal reflux disease (GERD) (OR=1.97; 95% CI: 1.19-3.27), and chronic pharyngitis (OR=1.83; 95% CI: 1.32-2.54).

Conclusions: No significant association was found between previous smoking history and current OSA severity. OSA patients with a history of smoking had an increased risk of hypertension, COPD, GERD, and chronic pharyngitis.

Keywords: comorbidities; obstructive sleep apnea; polysomnography; smoking.