Breathing bad: increased risk for obstructive sleep apnea in current and former smokers

Obstructive sleep apnea (OSA) and smoking are both prevalent and impactful health risks. While smoking may contribute to OSA through inflammatory and neuromuscular pathways, population-based evidence on this relationship remains limited and inconsistent. A sample (N = 1,206) from the population-based Study of Health in Pomerania with complete overnight polysomnography and smoking assessment was investigated in a cross-sectional study for an association between OSA and former as well as recent smoking status. Regression models adjusted for Age and BMI were applied. Current smoking was significantly associated with increased apnea-hypopnea-index (AHI) severity (OR = 1.75, 95% CI 1.27; 2.41, p < .001), with stratified analyses confirming the effect across younger and older participants. Former smokers also showed significantly elevated AHI severity compared to never-smokers (OR = 1.76, 95% CI 1.27; 2.43, p < .001). Both current and former smoking were significantly associated with greater OSA severity in this population-based sample, even after accounting for age and BMI. The findings underscore the long-term respiratory consequences of smoking and highlight the need for integrated approaches in smoking cessation and OSA screening.