Effects of smoking on patients with obstructive sleep apnea syndrome

Objectives We aimed to investigate the relationship between the presence and severity of obstructive sleep apnea (OSAS) and smoking using pulmonary function tests and polysomnographic data. Materials and Methods This analytical cross-sectional study was done by retrospectively examining the files of patients who applied to the Meram Medical Faculty Chest Diseases Sleep Laboratory between 07.01.2016 and 30.12.2018. Three-hundred and thirty-three patients who were diagnosed with OSAS or simple snoring by polysomnography (PSG) were included in the study. Results Those involved in the study; 17.1% were simple snoring [apnea-hypopnea index (AHI) < 5]; 15.3% were mild OSAS (AHI: 5-15); 30.6% were moderate OSAS (AHI: 16-30); 36.9% were severe OSAS (AHI > 30), and 48.6% of the study participants never smoked. There was a significant correlation between the number of pack-years, minimum O(2)saturation, mean O(2)saturation, ratio of sleep time to total sleep time with oxygen saturation below 90%, %NREM 3 sleep time, Hb, HTC values, and FEV1/FVC values. According to the results of multiple linear regression analysis; the effect of package-year, age, and BMI on OSAS severity was found to be statistically significant (beta = 0.153P = 0.004,beta = 0.123P = 0.025,beta = 0.208P < 0.001, respectively). Conclusion It was revealed that patients with severe OSAS were heavy smokers, and increased smoking increased the OSAS severity both by increasing the AHI and by reducing the oxygen saturation overnight. One unit increase in the package-year results in a 15.3% increase in the AHI.