Smoking Related to Obstructive Sleep Apnea Severity

Close-Up Of Polysomnography Graph OSA
Smoking may be related to the severity of obstructive sleep apnea.

About half of newly diagnosed patients with obstructive sleep apnea (OSA) have a severe form of the disease, which was affected by smoking status, according to a study published in Advances in Respiratory Medicine.

This retrospective analysis of 5353 patients with suspected OSA was designed to assess the incidence of new OSA diagnoses in those presenting with sleep disorder symptoms, the relationship between smoking and OSA severity, and the prevalence of cardiovascular comorbidities in ever-smokers compared with never-smokers within this population. Polysomnography was used to diagnose OSA.

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A total of 3613 (67.5%) were diagnosed with OSA (49.0% severe cases), and among the newly diagnosed OSA patients, 21.6% were smokers. Patients with OSA who smoked had a higher apnea-hypopnea index than those who did not (apnea-hypopnea index, 31 vs 29; P <.05), lower mean oxygenation during sleep (90.9±4.0 vs 91.5±3.7; P <.001), and a higher daytime sleepiness score (Epworth Sleepiness Scale score 11.7±5.5 vs 11.0±5.5; P <.001). Hypertension was the most frequent comorbidity, followed by obesity, type 2 diabetes, and coronary artery disease, with a statistically higher incidence of hypertension observed in nonsmokers (59.2% vs 64.7%; P <.01).

Study investigators concluded, “Smoking was related [to] OSA severity and more pronounced abnormalities during sleep and increased daytime sleepiness. Our findings on the impact of smoking status on the course of OSA and OSA cardiovascular comorbidities need to be confirmed in large population prospective studies.”


Bielicki P, Trojnar A, Sobieraj P, Wąsik M. Smoking status in relation to obstructive sleep apnea severity (OSA) and cardiovascular comorbidity in patients with newly diagnosed OSA. Adv Respir Med. 2019;87(2):103-109.