How Does Smoking Affect Sleep Apnea?

Smoking affects sleep apnea in many ways.

Struggling with sleep apnea? If so, it’s important to pay attention to the effects of smoking on this condition. It is common knowledge that smoking can have detrimental effects on our overall health, but the impact it has on sleep apnea may surprise you.

Sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep. This can result in disruptive snoring, excessive daytime sleepiness and other serious medical conditions such as cardiovascular issues or stroke. People with these severe symptoms are often prescribed continuous positive airway pressure (CPAP) machines to help them breathe while they’re sleeping.

However, even when using a CPAP machine it’s important to be aware of how smoking cigarettes may influence your overall health and sleep apnea symptoms. In this article, we will explore the connection between the two and discuss ways to reduce the risk associated with both conditions.

How does smoking and sleep apnea relate?

There is an established link between smoking and obstructive sleep apnea (OSA), with research suggesting that smoking increases the risk of developing sleep apnea. Kim et al demonstrated a higher prevalence of smoking among those with OSA (35%) compared to those without this condition (18%), indicating a strong association between the two phenomena.

The University of Wisconsin Sleep Cohort Study conducted overnight polysomnography and health interviews with 811 participants, which is one of the largest cohort studies regarding OSA in the United States. Data analysis found that, after adjusting for sex, age, BMI, education, daily amount of caffeinated beverages, and weekly number of alcoholic beverages, current smokers had a greater odds of moderate or severe OSA than nonsmokers. Smoking two or more packs of cigarettes per day was linked to a greater risk of mild and moderate or severe OSA as well.

Though, no association was found between prior smoking and OSA, which may indicate that the effect of smoking on OSA risk is of short duration or that the sample size of this large epidemiologic study was too small to detect a difference. Evidence from these studies suggests that smoking may be associated with OSA, regardless of the presence of COPD.This also suggests that people who smoke may be more likely to be diagnosed with OSA.

However, not all studies have found this correlation. In the Sleep Heart Health Study researchers surveyed 6,132 participants recruited from ongoing cardiovascular and respiratory studies and did not find any worsening of OSA symptoms in regular smokers when compared to non-smokers. Though, former smokers did have worsening OSA symptoms compared to never-smokers.

It is unknown why this study was different than others. Further research into the associated links between smoking and OSA will likely provide invaluable insight into how both can be managed through lifestyle changes or medical interventions if necessary.

How does smoking affect sleep apnea?

Smoking affects sleep apnea in these ways:

Airway Inflammation

Cigarette smoke is one of the most dangerous things that we can expose our body to. It contains toxic substances known to cause inflammation in the upper airway when inhaled. This inflammation has a narrowing effect on the airways, making it more difficult to breathe. In order to combat this inflammation, our bodies launch an immune response which involves an increase in mucus production. While the purpose of this excess mucus is to help to trap and remove the irritants from our airways, its presence can also create an obstruction which further depresses our ability to take in sufficient oxygen.

Those exposed to cigarette smoke for extended periods of time can find themselves suffering from chronic airway inflammation as their bodies are unable to keep up with cleaning out all the toxins and impurities from their respiratory system. Smoking-related diseases such as bronchitis and asthma are often linked directly back to this unchecked inflammatory response which taxes both the lungs and the overall respiration process. Fortunately, avoiding smoking altogether is one surefire way of preventing any ensuing effects caused by inhaling dangerous substances into your body.

Nicotine Relaxes Muscles

We all know nicotine is an addictive substance. It keeps individuals coming back for more, but what many may not realize is that nicotine can also have a number of effects on the body. One way in which it can do this is by relaxing the upper airway muscles. This can increase a person’s potential to suffer from obstructive sleep apnea.

Relaxing the upper airway muscles reduces the tone and strength of those muscles, resulting in an increased risk of blocked airway passages. Individuals who smoke or use tobacco products are more likely to experience OSA compared to non-smokers due to the risk of the airways becoming blocked while they sleep. Furthermore, nicotine withdrawal could cause breathing problems while someone sleeps as these muscles return to their pre-relaxed state, thus contributing further to OSA susceptibility in individuals who struggle with quitting smoking or nicotine use.

Nicotine Causes Awakenings

Nicotine disrupts sleep in many and complex ways. As a stimulant, nicotine interferes with the body’s natural ability to fall asleep and stay asleep. Although it may provide an initial burst of energy, this burst fades quickly causing fatigue. This can be especially detrimental for people suffering from sleep disorders such as sleep apnea because their sleeping habits are already disrupted.

On top of this, nicotine is addictive which triggers the release of adrenaline in small amounts throughout the night even without any external stimulus. The repeated rushes of adrenaline cause regular awakenings during the night and decrease overall quality of sleep for smokers. This makes it difficult for smokers to rest peacefully, leaving them tired and unrested during daytime hours despite hours spent in bed at night.


As mentioned and proven above with the studies that show smoking and sleep apnea do not go well together, smoking is not good for your health or sleep apnea.

Smoking affects sleep apnea in negative ways. Smoking has a direct correlation with OSA due to its effects on narrowing and weakening of the tissues within the upper airways. Heavy smokers are more likely to suffer from OSA than those who are non-smokers or light smokers. The results of studies also suggest that any amount of cigarette smoking can lead to an increased number of episodes of OSA.

It is believed that smoking acts as an irritant for the upper airways through damaging of these sensitive tissues and affects various airflow dynamics so as to cause obstruction during sleep. High levels of carbon monoxide in the bloodstreams commonly caused by smoking impair oxygen uptake and delivery, leading to further disruption in breathing cycles during sleep. To sum up, it can be seen that there is a clear link with sleep apnea and smoking that should encourage individuals who smoke to seek medical help as soon as possible if they suspect they are suffering from this disorder.

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