| Summary: | Introduction
Although previous studies have addressed the association between
smoking and obstructive sleep apnea (OSA), there are few studies on the
association between electronic cigarette use and OSA. Thus, we aimed to evaluate
the association between the dual use of electronic and conventional cigarettes
and OSA.
Methods
Data from 7350 participants of the 2019–2021 Korean National Health
and Nutrition Examination Survey were analyzed in this population-based study.
The STOP-Bang score was calculated using eight items: snoring, tiredness,
observed apnea, high blood pressure, body mass index, age, neck circumference,
and sex. The main independent variable was smoking behavior. A multiple logistic
regression analysis was performed. Subgroup analysis was conducted to analyze
the association between smoking behavior in detail and OSA, and stratified
analyses were additionally performed.
Results
Of the 7350 participants, 417 (5.7%) had a high risk of OSA, according to
the STOP-Bang score. Compared to the non-smoker group, the dual user group
had a 2.46-fold increase in the odds of OSA (adjusted odds ratio, AOR = 2.45; 95% CI: 1.04-5.79). Current non-smokers who were dual users in the past had
increased odds of having OSA (AOR=3.61; 95% CI: 1.32–9.92). In the stratified
analyses, dual cigarette use was significantly associated with OSA in females and
those with a low physical activity level.
Conclusions
Dual users and cigarette-only users had an increased probability of
developing OSA. Even if they are not currently smoking or vaping, individuals
who were dual users in the past were associated with a higher risk of OSA. The
association between dual cigarette use and OSA was more pronounced in females
and those with a low physical activity level. While intervening for obstructive sleep
apnea or investigating risk factors, new smoking methods such as vaping and dual
use should be considered along with conventional smoking.
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