Sleep Apnea in Smokers vs Non-Smokers

According to the Center for Disease Control (CDC), about 18% of the adult population regularly smokes cigarettes in the United States. These estimates vary by gender, ethnicity, socioeconomic status, and even state, but overall, the rate is pretty high. There is no need to discuss how smoking cigarettes affects overall health, but can it affect sleep apnea? And, also importantly, how do things change after an individual quits smoking? Does it matter? These questions were recently investigated.

Three groups of individuals were investigated in this study: those who have never smoked, those who used to smoke but quit, and current smokers. Participants who were former smokers and current smokers were questioned about smoking habits (how many cigarettes per day, how many years, etc.). All participants underwent an overnight sleep study, and the presence and severity of sleep apnea was assessed. Sleep apnea parameters, including the apnea hypopnea index (AHI) and oxygen loss during sleep, were compared with smoking statistics in search of a relationship between smoking and apnea. 

Results showed that there were more men smokers than women, which is consistent with the nationwide statistics. There were also more men with sleep apnea than women (also a common finding). Within the smokers group, those who had smoked for more years had a higher AHI, meaning they had more apneas per hour. Those who smoked more also spent less time in deep sleep stages and spent more time in light stages. And finally, when comparing former smokers to those who never smoked, the former smokers spent more time with low oxygen levels (due to apneas) during the night.

Overall, it seems that smoking cigarettes may exacerbate or worsen sleep apnea severity. Although former smokers have worse sleep apnea outcomes than those who have never smoked, those who quit are still better off than current smokers. These data align with other findings on smoking, which state that quitting immediately improves health outcomes. It would be interesting to see how long one must quit smoking in order for sleep apnea to “normalize” to less severe levels.

Varol, Y., Anar, C., Tuzel, O. E., Guclu, S. Z., & Ucar, Z. Z. (2015). The impact of active and former smoking on the severity of obstructive sleep apnea. Sleep and Breathing, 1-6.

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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