Wetter D W, Young T B, Bidwell T R, Badr M S, Palta M
Center for Tobacco Research and Intervention, University of Wisconsin, Madison.
Arch Intern Med. 1994 Oct 10;154(19):2219-24.
Recent evidence indicates that the prevalence of sleep-disordered breathing is remarkably high (24% for men and 9% for women) and that the public health burden attributable to sleep-disordered breathing is substantial. This investigation examines current and former cigarette smoking as potential risk factors for sleep-disordered breathing.
Data were from 811 adults enrolled in the University of Wisconsin Sleep Cohort Study, Madison. The Sleep Cohort Study is a longitudinal, epidemiologic study that uses nocturnal polysomnography to investigate sleep-disordered breathing and other disorders of sleep. The presence and severity of sleep-disordered breathing was quantified by the frequency of apneas and hypopneas per hour of sleep.
Logistic regression analyses were used to control for potential confounding factors. Compared with never smokers, current smokers had a significantly greater risk of snoring (odds ratio, 2.29) and of moderate or worse sleep-disordered breathing (odds ratio, 4.44). Heavy smokers (> or = 40 cigarettes per day) had the greatest risk of mild sleep-disordered breathing (odds ratio, 6.74) and of moderate or worse sleep-disordered breathing (odds ratio, 40.47). Former smoking was unrelated to snoring and sleep-disordered breathing after adjustment for confounders.
Current cigarette smokers are at greater risk for sleep-disordered breathing than are never smokers. Heavy smokers have the greatest risk while former smokers are not at increased risk for sleep-disordered breathing. Thus, smoking cessation should be considered in the treatment and prevention of sleep-disordered breathing.
最近的证据表明，睡眠呼吸障碍的患病率非常高（男性为24%，女性为9%），且睡眠呼吸障碍所致的公共卫生负担相当大。本研究调查当前及既往吸烟情况作为睡眠呼吸障碍的潜在危险因素。
数据来自麦迪逊市威斯康星大学睡眠队列研究中的811名成年人。睡眠队列研究是一项纵向流行病学研究，采用夜间多导睡眠图来调查睡眠呼吸障碍及其他睡眠障碍。睡眠呼吸障碍的存在及严重程度通过每小时睡眠中呼吸暂停和低通气的频率来量化。
采用逻辑回归分析来控制潜在的混杂因素。与从不吸烟者相比，当前吸烟者打鼾的风险显著更高（比值比为2.29），出现中度或更严重睡眠呼吸障碍的风险也显著更高（比值比为4.44）。重度吸烟者（每天≥40支烟）出现轻度睡眠呼吸障碍的风险最高（比值比为6.74），出现中度或更严重睡眠呼吸障碍的风险也最高（比值比为40.47）。在对混杂因素进行调整后，既往吸烟与打鼾及睡眠呼吸障碍无关。
当前吸烟者比从不吸烟者患睡眠呼吸障碍的风险更高。重度吸烟者风险最高，而既往吸烟者患睡眠呼吸障碍的风险并未增加。因此，在睡眠呼吸障碍的治疗和预防中应考虑戒烟。
