Synergy of Smoking and Obstructive Sleep Apnea: Cardiovascular Comorbidity and Oxygenation Impact

<bold>Introduction:</bold> Obstructive Sleep Apnea (OSA)and smoking have both been individually closely associated with increased cardiorespiratory comorbidity. <bold>Objectives:</bold> We aim to compare cardiorespiratory differences, considering the presence or absence of OSA(Apnea-Hypopnea Index(AHI)≥15) and tobacco burden(TB)(PY>15). <bold>Methods:</bold> Our single center retrospective study included patients that received a sleep disorder consultation from 01/12/2020 to 24/01/2023. Four groups were established:patients with no OSA+no TB (Group A), no OSA+TB (Group B),OSA+no TB (Group C) and OSA+TB(Group D). To assess differences between groups, a comparative study was conducted using multinomial logistic regression with the reference Group A. <bold>Results:</bold>915 patients were included, of whom 70.9% were male, with a median age of 59 years. Suffering from arterial hypertension(AHT) and being male is more common in Group D(OR 2.76,p=0.01;OR 5.74,p=0.01). Smoking has a greater impact on the development of ischemic cardiopathy(IC) compared to experiencing OSA(OR 11.33,p=0.03). Respiratory insufficiency(RI) is more prevalent in individuals with OSA than in smokers(OR 1.78,p=0.01). Figure 1. <bold>Conclusions:</bold> OSA and TB appear to have a synergistic effect and influence in AHT. Our results suggest that TB plays a more significant role in the development of IC,while OSA plays a greater role in the development of RI than smoking.