Smoking and sleep apnea
It’s no secret that smoking can seriously affect your health, but if sleep apnea is also present, the consequences can be even worse. If you smoke and suffer from sleep apnea or know someone who does, you may be wondering how smoking affects sleep apnea and overall sleep.
Smoking interferes with your body's natural sleep cycle and can have long-lasting effects on your ability to sleep soundly. The nicotine found in cigarettes causes physiological reactions that awaken your body, can cause airway obstruction and inflammation in the nose and upper respiratory tract, and interfere with the success of CPAP therapy.
Effects of smoking on sleep
Nicotine is a stimulant, like sugar and coffee, and according to research, it can alter the expression of clock genes (circadian rhythms) in the lungs and brain, with long-term effects.
Smoking causes frequent wakings, snoring, and makes it harder to fall asleep. It can also act as an irritant, causing swelling in the nose and throat, reducing the space for air to circulate. This causes your throat tissue to become more irritated and swollen, making it difficult to breathe, leading to obstructive sleep apnea.
Just as you wouldn't drink a cup of espresso to "relax" before bed, a cigarette before bed actually introduces powerful stimuli into the bloodstream that can lead to insomnia and/or sleep-disordered breathing, rather than relaxing your body .
Does smoking worsen sleep apnea?
If you smoke, smoking puts you at a higher risk of developing obstructive sleep apnea and may increase its severity. Research shows that smokers are more likely to develop obstructive sleep apnea than non-smokers and former smokers combined.
Smoking increases the risk and severity of obstructive sleep apnea for many reasons: it disrupts sleep architecture (circadian rhythm and sleep cycles), it impairs upper airway muscle function, disrupts sleep and inflames it, or it increases mucus in the upper airway Congestion.
Risks of Smoking with Sleep Apnea
Sleep apnea and smoking can independently affect your breathing, but together they amplify the negative effects on your airways. The combination of smoking and non-CPAP compliance also becomes dangerous because they both trigger similar risk factors related to stroke, diabetes, airway inflammation, high blood pressure, and heart problems.
Are e-cigarettes harmful to your sleep?
possible. While e-cigarettes may reduce some of the health risks associated with smoking, they still deliver nicotine to your body. Vaping with flavored nicotine products has been linked to an irreversible, serious lung disease (bronchiolitis obliterans) and can disrupt sleep. If your e-liquid contains nicotine, it can affect your sleep.
Take a deep breath
For some people, transitioning to CPAP therapy can be challenging, although adhering to treatment has been shown to treat sleep apnea. Some studies also show that staying on CPAP can even help you quit smoking. Smoking severely affects your ability to breathe and adds physical stress to your body, airways, and lungs. Unfortunately, it can also make your obstructive sleep apnea worse.
By starting and sticking to CPAP treatment without compromise, you can get the sleep you deserve and feel better, which may help you make other positive health choices, such as quitting smoking.
Are sleep apnea patients more likely to smoke?
Although we found no longitudinal studies of the incidence of smoking in patients with and without OSA, a hypothesis was proposed in 1994 that has not yet been tested. Wetter et al. and Schrand believe that with undiagnosed OSA there are psychological, emotional, physical and social rewards of smoking. Wetter et al suggested that people with frequent sleep disorders (such as those with OSA) have non-restorative sleep, difficulty waking up, and daytime sleepiness, which leads them to self-medicate with smoking .
Nicotine increases dopamine levels in the nucleus accumbens. The resulting increase in dopamine release has been shown to cause feelings of arousal and reward, both of which have the potential to lead to addiction. Hypoxia has also been found to affect the release of dopamine levels in the carotid artery. Collins speculates that, through adaptation, chronic hypoxia (such as that observed in OSA) may be responsible for the greater number of nicotine binding sites observed in smokers. An increase in the number of nicotine binding sites is known to further exacerbate the vicious cycle of smoking. More available nicotine receptors may lead to increased smoking frequency. In cases of chronic hypoxia due to hypoventilation or apnea, smoking (via nicotine) temporarily increases ventilation while stimulating pleasure/reward centers, promoting addiction and compulsive activity. Additionally, social pressures, such as the desire for mental alertness and a slim physique, may influence tobacco use in obese, sleepy OSA patients.
Nicotine also stimulates serotonergic neurons in the dorsal pontine nucleus. Stimulation of these neurons has been hypothesized to be associated with improved mood in patients with major depression who smoke. Depression and mood disorders are common in patients with sleep apnea and therefore may represent another reason why people with OSA may become addicted to smoking.
