Although the relationship between tobacco and respiratory diseases such as chronic obstructive pulmonary disease (COPD) or lung cancer is widely documented, less known is its direct impact on sleep quality. Smoking significantly alters nighttime rest cyclesaffecting both the architecture of sleep and the effectiveness of respiratory treatments such as CPAP (continuous positive airway pressure), essential in obstructive sleep apnea (OSA).
Nicotine stimulates the central nervous system, increases heart rate, increases blood pressure and activates the brain, interfering with the physiological processes that induce deep sleep. In fact, different research published in prestigious journals such as the Journal of Clinical Sleep Medicine concludes that nicotine consumption reduces slow wave sleep and REM sleep, and increases sleep latency, which leads to less restful rest. In addition, smoking causes chronic inflammation in the upper airways, thickening them and promoting their collapse, which increases the frequency and intensity of apnea episodes.
“Smoking produces chronic inflammation in the upper airways, thickening them and promoting their collapse, increasing the frequency and intensity of apnea episodes,” explains Dr. Sandra Vañes, medical director of Linde Médica. “In addition, it interferes with adherence to the most common treatment, CPAP (continuous positive airway pressure), making its effectiveness and tolerance difficult,” he maintains.
Thus, experts call for broadening the approach: it is not enough to make lung damage visible. It is also necessary to include how tobacco compromises rest, worsens sleep pathologies and limits the response to key therapies.
Smoking and apnea, a risk combination
OSA affects 10-15% of the adult population and is characterized by repeated interruptions of breathing during sleepwith consequences such as daytime sleepiness, cognitive impairment, increased cardiovascular risk and a progressive decrease in quality of life.
Smoking acts as a direct aggravating factor: In addition to inflaming and irritating the upper airway, it increases the pharyngeal collapse that defines this pathology.. A study published in Scientific Reports indicates that smokers have a higher apnea-hypopnea index (AHI) and lower blood oxygen levels at night (nocturnal hypoxemia).
Added to this is a worrying fact: Smokers with OSA have lower adherence to CPAP treatment. They require higher pressures to achieve the same therapeutic effects and more frequently present symptoms such as nasal congestion, dryness or a feeling of suffocation, which can lead to abandoning the device. This translates into worse disease control, greater risk of cardiovascular complications and an accelerated deterioration in general health.
Dr. Vañes explains the difficulties in approaching these patients: “Smokers require higher pressures to keep the airway open.which can cause discomfort and reduce the comfort of the treatment. Nasal congestion, dryness or a feeling of suffocation is also common, which can cause them to abandon the use of the device prematurely, which has direct and serious consequences on their health: cardiovascular problems, cognitive impairment and depression. And all because of an avoidable habit.”
Given this reality, experts insist on the need to address respiratory health in a comprehensive way, detecting sleep disorders early and acting not only to prevent, but also to provide innovative solutions to those who already suffer from the consequences of smoking. “Quitting smoking is still the best treatment. But for those who already suffer from the effects of tobacco, advances in technology and the personalization of therapies represent a horizon of hope,” concludes Sandra Vañes.
