Smoking as a risk factor for sleep-disordered breathing.

BACKGROUND Recent evidence indicates that the prevalence of sleep-disordered breathing is remarkably high (24% for men and 9% for women) and that the public health burden attributable to sleep-disordered breathing is substantial. This investigation examines current and former cigarette smoking as potential risk factors for sleep-disordered breathing. METHODS Data were from 811 adults enrolled in the University of Wisconsin Sleep Cohort Study, Madison. The Sleep Cohort Study is a longitudinal, epidemiologic study that uses nocturnal polysomnography to investigate sleep-disordered breathing and other disorders of sleep. The presence and severity of sleep-disordered breathing was quantified by the frequency of apneas and hypopneas per hour of sleep. RESULTS Logistic regression analyses were used to control for potential confounding factors. Compared with never smokers, current smokers had a significantly greater risk of snoring (odds ratio, 2.29) and of moderate or worse sleep-disordered breathing (odds ratio, 4.44). Heavy smokers (> or = 40 cigarettes per day) had the greatest risk of mild sleep-disordered breathing (odds ratio, 6.74) and of moderate or worse sleep-disordered breathing (odds ratio, 40.47). Former smoking was unrelated to snoring and sleep-disordered breathing after adjustment for confounders. CONCLUSIONS Current cigarette smokers are at greater risk for sleep-disordered breathing than are never smokers. Heavy smokers have the greatest risk while former smokers are not at increased risk for sleep-disordered breathing. Thus, smoking cessation should be considered in the treatment and prevention of sleep-disordered breathing.

[1]  T. Young,et al.  The occurrence of sleep-disordered breathing among middle-aged adults. , 1993, The New England journal of medicine.

[2]  A I Pack,et al.  Correlation between oscillations in ventilation and frequency content of the electroencephalogram. , 1992, Journal of applied physiology.

[3]  D. Hillman,et al.  Association of sleep apnoea with myocardial infarction in men , 1990, The Lancet.

[4]  J. Samet,et al.  Snoring in a Hispanic-American population. Risk factors and association with hypertension and other morbidity. , 1990, Archives of internal medicine.

[5]  R. Millman,et al.  Depression as a manifestation of obstructive sleep apnea: reversal with nasal continuous positive airway pressure. , 1989, The Journal of clinical psychiatry.

[6]  A. J. Block,et al.  Mortality and sleep apnea. The trouble with looking backward. , 1988, Chest.

[7]  M. Kryger,et al.  Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. , 1988, Chest.

[8]  S. Quan,et al.  Risk factors in a general population for snoring. Importance of cigarette smoking and obesity. , 1988, Chest.

[9]  D. Deptula,et al.  Neuropsychological dysfunction in sleep apnea. , 1987, Sleep.

[10]  D. Hatsukami,et al.  Signs and symptoms of tobacco withdrawal. , 1986, Archives of general psychiatry.

[11]  A J Block,et al.  Indications and standards for cardiopulmonary sleep studies. , 1985, Sleep.

[12]  E. Bruce,et al.  Action of nicotine on the respiratory activity of the diaphragm and genioglossus muscles and the nerves that innervate them. , 1984, Respiration physiology.

[13]  D. Kupfer,et al.  Depressive psychopathology in male sleep apneics. , 1984, The Journal of clinical psychiatry.

[14]  N. Benowitz,et al.  Circadian blood nicotine concentrations during cigarette smoking , 1982, Clinical pharmacology and therapeutics.

[15]  C. Sullivan,et al.  Alcohol, snoring and sleep apnea. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[16]  A J Block,et al.  Alcohol increases sleep apnea and oxygen desaturation in asymptomatic men. , 1981, The American journal of medicine.

[17]  G. Burke,et al.  Misclassification of smoking status in the CARDIA study: a comparison of self-report with serum cotinine levels. , 1992, American journal of public health.

[18]  M. Vitiello,et al.  Relationship of alcohol abuse history to nighttime hypoxemia in abstaining chronic alcoholic men. , 1990, Journal of studies on alcohol.

[19]  K. Strohl,et al.  Nicotine: a different approach to treatment of obstructive sleep apnea. , 1985, Chest.

[20]  E. Bixler,et al.  Severe obstructive sleep apnea--I: Onset, clinical course, and characteristics. , 1985, Journal of chronic diseases.