The Impact of Smoking Status on Obstructive Sleep Apnea: Insights from Anthropometric and Physiological Covariates

Smoking status has been implicated as a risk factor for various respiratory disorders, but its relationship with obstructive sleep apnea (OSA) remains controversial. This study explored the association between smoking status (current, former, and non-smokers) and apnea-hypopnea index (AHI) across smoking groups while considering anthropometric parameters such as sex, age, BMI, Mallampati score, and neck circumference. A Gamma generalized linear model (GLM) was used to determine the effect of smoking status in the presence of physiological covariates including sex, age, BMI, and Mallampati score. Findings revealed that current-smokers had significantly different AHI values compared to former-smokers and non-smokers, particularly within male and high neck circumference subgroups. Moreover, the adjusted GLM model showed that the effect of smoking status on AHI was attenuated when these covariates were considered. The results of this study are encouraging to be further investigated in larger and more balanced datasets while considering the smoking cessation duration.Clinical Relevance- This study explores the potential impacts of smoking status on the severity of obstructive sleep apnea. Understanding the underlying association helps clinicians consider smoking history during OSA diagnosis and management alongside other key anthropometric features. The finding could guide clinicians in developing personalized treatment strategies.