Sex Differences in the Association Between Smoking and Sleep-Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

Oren Cohen, Garrett M. Strizich, Alberto Ramos, Phyllis C. Zee, Kathryn J. Reid, Venkatesh Mani, David M. Rapoport, S. Redline, Robert C. Kaplan, Neomi A. Shah

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Results of previous studies examining associations between cigarette smoking and sleep-disordered breathing (SDB) are inconsistent. We therefore investigated this association in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: A total of 13,863 US Hispanic/Latino subjects, 18 to 76 years old, provided smoking histories and underwent home SDB testing. Logistic regression analyses were conducted to assess the independent association of smoking and SDB with covariate adjustment. Sex- and age-stratified analyses were performed. Results: The weighted prevalence of moderate to severe SDB was 9.7% (95% CI, 9.0-10.5). No independent and statistically significant association was observed between ever smoking (defined as minimum lifetime cigarette use of 100) and moderate to severe SDB (defined as an apnea-hypopnea index ≥ 15 events per hour) (OR, 1.02; 95% CI, 0.85-1.22; P = .85). Sex and age were effect modifiers of the aforementioned association. Stratification according to age and sex revealed that younger (aged 35-54 years) female smokers had 83% higher odds of SDB compared with younger female never smokers (OR, 1.83; 95% CI, 1.19-2.81; P = .01). A significant dose-response relation was noted between smoking intensity and SDB in younger female smokers (P < .01). Lastly, use of ≥ 10 cigarettes per day was associated with a nearly threefold increase in SDB odds in younger female ever smokers. These associations were not observed in younger male subjects. Conclusions: In the HCHS/SOL, no independent and statistically significant association was found between smoking and SDB. Sex and age stratification revealed a novel statistically significant association between smoking and SDB in younger (35-54 years old) female smokers. Our findings highlight the importance of investigating sex- and age-specific associations of SDB risk factors.

Original languageEnglish (US)
JournalCHEST
DOIs
StateAccepted/In press - Jan 1 2019
Externally publishedYes

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Sleep Apnea Syndromes
Hispanic Americans
Sex Characteristics
Smoking
Health
Tobacco Products
Social Adjustment
Apnea
Logistic Models
Regression Analysis

Keywords

  • Hispanic/Latino
  • sleep-disordered breathing
  • smoking

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Sex Differences in the Association Between Smoking and Sleep-Disordered Breathing in the Hispanic Community Health Study/Study of Latinos. / Cohen, Oren; Strizich, Garrett M.; Ramos, Alberto; Zee, Phyllis C.; Reid, Kathryn J.; Mani, Venkatesh; Rapoport, David M.; Redline, S.; Kaplan, Robert C.; Shah, Neomi A.

In: CHEST, 01.01.2019.

Research output: Contribution to journalArticle

Cohen, Oren ; Strizich, Garrett M. ; Ramos, Alberto ; Zee, Phyllis C. ; Reid, Kathryn J. ; Mani, Venkatesh ; Rapoport, David M. ; Redline, S. ; Kaplan, Robert C. ; Shah, Neomi A. / Sex Differences in the Association Between Smoking and Sleep-Disordered Breathing in the Hispanic Community Health Study/Study of Latinos. In: CHEST. 2019.
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abstract = "Background: Results of previous studies examining associations between cigarette smoking and sleep-disordered breathing (SDB) are inconsistent. We therefore investigated this association in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: A total of 13,863 US Hispanic/Latino subjects, 18 to 76 years old, provided smoking histories and underwent home SDB testing. Logistic regression analyses were conducted to assess the independent association of smoking and SDB with covariate adjustment. Sex- and age-stratified analyses were performed. Results: The weighted prevalence of moderate to severe SDB was 9.7{\%} (95{\%} CI, 9.0-10.5). No independent and statistically significant association was observed between ever smoking (defined as minimum lifetime cigarette use of 100) and moderate to severe SDB (defined as an apnea-hypopnea index ≥ 15 events per hour) (OR, 1.02; 95{\%} CI, 0.85-1.22; P = .85). Sex and age were effect modifiers of the aforementioned association. Stratification according to age and sex revealed that younger (aged 35-54 years) female smokers had 83{\%} higher odds of SDB compared with younger female never smokers (OR, 1.83; 95{\%} CI, 1.19-2.81; P = .01). A significant dose-response relation was noted between smoking intensity and SDB in younger female smokers (P < .01). Lastly, use of ≥ 10 cigarettes per day was associated with a nearly threefold increase in SDB odds in younger female ever smokers. These associations were not observed in younger male subjects. Conclusions: In the HCHS/SOL, no independent and statistically significant association was found between smoking and SDB. Sex and age stratification revealed a novel statistically significant association between smoking and SDB in younger (35-54 years old) female smokers. Our findings highlight the importance of investigating sex- and age-specific associations of SDB risk factors.",
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author = "Oren Cohen and Strizich, {Garrett M.} and Alberto Ramos and Zee, {Phyllis C.} and Reid, {Kathryn J.} and Venkatesh Mani and Rapoport, {David M.} and S. Redline and Kaplan, {Robert C.} and Shah, {Neomi A.}",
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T1 - Sex Differences in the Association Between Smoking and Sleep-Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

AU - Cohen, Oren

AU - Strizich, Garrett M.

AU - Ramos, Alberto

AU - Zee, Phyllis C.

AU - Reid, Kathryn J.

AU - Mani, Venkatesh

AU - Rapoport, David M.

AU - Redline, S.

AU - Kaplan, Robert C.

AU - Shah, Neomi A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Results of previous studies examining associations between cigarette smoking and sleep-disordered breathing (SDB) are inconsistent. We therefore investigated this association in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: A total of 13,863 US Hispanic/Latino subjects, 18 to 76 years old, provided smoking histories and underwent home SDB testing. Logistic regression analyses were conducted to assess the independent association of smoking and SDB with covariate adjustment. Sex- and age-stratified analyses were performed. Results: The weighted prevalence of moderate to severe SDB was 9.7% (95% CI, 9.0-10.5). No independent and statistically significant association was observed between ever smoking (defined as minimum lifetime cigarette use of 100) and moderate to severe SDB (defined as an apnea-hypopnea index ≥ 15 events per hour) (OR, 1.02; 95% CI, 0.85-1.22; P = .85). Sex and age were effect modifiers of the aforementioned association. Stratification according to age and sex revealed that younger (aged 35-54 years) female smokers had 83% higher odds of SDB compared with younger female never smokers (OR, 1.83; 95% CI, 1.19-2.81; P = .01). A significant dose-response relation was noted between smoking intensity and SDB in younger female smokers (P < .01). Lastly, use of ≥ 10 cigarettes per day was associated with a nearly threefold increase in SDB odds in younger female ever smokers. These associations were not observed in younger male subjects. Conclusions: In the HCHS/SOL, no independent and statistically significant association was found between smoking and SDB. Sex and age stratification revealed a novel statistically significant association between smoking and SDB in younger (35-54 years old) female smokers. Our findings highlight the importance of investigating sex- and age-specific associations of SDB risk factors.

AB - Background: Results of previous studies examining associations between cigarette smoking and sleep-disordered breathing (SDB) are inconsistent. We therefore investigated this association in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: A total of 13,863 US Hispanic/Latino subjects, 18 to 76 years old, provided smoking histories and underwent home SDB testing. Logistic regression analyses were conducted to assess the independent association of smoking and SDB with covariate adjustment. Sex- and age-stratified analyses were performed. Results: The weighted prevalence of moderate to severe SDB was 9.7% (95% CI, 9.0-10.5). No independent and statistically significant association was observed between ever smoking (defined as minimum lifetime cigarette use of 100) and moderate to severe SDB (defined as an apnea-hypopnea index ≥ 15 events per hour) (OR, 1.02; 95% CI, 0.85-1.22; P = .85). Sex and age were effect modifiers of the aforementioned association. Stratification according to age and sex revealed that younger (aged 35-54 years) female smokers had 83% higher odds of SDB compared with younger female never smokers (OR, 1.83; 95% CI, 1.19-2.81; P = .01). A significant dose-response relation was noted between smoking intensity and SDB in younger female smokers (P < .01). Lastly, use of ≥ 10 cigarettes per day was associated with a nearly threefold increase in SDB odds in younger female ever smokers. These associations were not observed in younger male subjects. Conclusions: In the HCHS/SOL, no independent and statistically significant association was found between smoking and SDB. Sex and age stratification revealed a novel statistically significant association between smoking and SDB in younger (35-54 years old) female smokers. Our findings highlight the importance of investigating sex- and age-specific associations of SDB risk factors.

KW - Hispanic/Latino

KW - sleep-disordered breathing

KW - smoking

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