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While smoking may contribute to OSA through inflammatory and neuromuscular pathways, population-based evidence on this relationship remains limited and inconsistent. A sample (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20091,206) from the population-based Study of Health in Pomerania with complete overnight polysomnography and smoking assessment was investigated in a cross-sectional study for an association between OSA and former as well as recent smoking status. Regression models adjusted for Age and BMI were applied. Current smoking was significantly associated with increased apnea-hypopnea-index (AHI) severity (OR\u2009=\u20091.75, 95% CI [1.27; 2.41],\n                    <jats:italic>p<\/jats:italic>\n                    &lt; .001), with stratified analyses confirming the effect across younger and older participants. Former smokers also showed significantly elevated AHI severity compared to never-smokers (OR\u2009=\u20091.76, 95% CI [1.27; 2.43],\n                    <jats:italic>p<\/jats:italic>\n                    &lt; .001). Both current and former smoking were significantly associated with greater OSA severity in this population-based sample, even after accounting for age and BMI. The findings underscore the long-term respiratory consequences of smoking and highlight the need for integrated approaches in smoking cessation and OSA screening.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-48908-2","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:53:48Z","timestamp":1777010028000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Breathing bad: increased risk for obstructive sleep apnea in current and former smokers"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-5668","authenticated-orcid":false,"given":"Markus","family":"Kr\u00fcger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-2716","authenticated-orcid":false,"given":"Christiane","family":"Pink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8532-5196","authenticated-orcid":false,"given":"Hanyi","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-0027","authenticated-orcid":false,"given":"Antoine","family":"Weihs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-8237","authenticated-orcid":false,"given":"Chia-Jung","family":"Busch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-6450","authenticated-orcid":false,"given":"Christian","family":"Scharf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bremert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-9925","authenticated-orcid":false,"given":"Ralf","family":"Ewert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-0502","authenticated-orcid":false,"given":"Anne","family":"Obst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-0112","authenticated-orcid":false,"given":"Thomas","family":"Penzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-5206","authenticated-orcid":false,"given":"Ingo","family":"Fietze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Korda\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9605-2822","authenticated-orcid":false,"given":"Thomas","family":"Kocher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0181-1388","authenticated-orcid":false,"given":"Reiner","family":"Biffar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7003-399X","authenticated-orcid":false,"given":"Henry","family":"V\u00f6lzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-1025","authenticated-orcid":false,"given":"Amro","family":"Daboul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"48908_CR1","doi-asserted-by":"crossref","unstructured":"Bonnie, R. 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RE reports research support from L\u00f6wenstein Medical; grants and\/or lecture honoraria from Janssen Germany, OMT Germany, AOP, Boehringer Ingelheim, and Berlin Chemie; consulting fees from AOP Germany and Janssen Germany; travel support from Novartis Germany and Janssen Germany; and advisory board roles with AOP Germany and Janssen Germany. All authors affirm that they received no financial support related to this work other than as disclosed above. The tobacco and nicotine delivery industry had no involvement in this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Data retrospectively examined in this study is part of the population-based Study of Health in Pomerania (SHIP) approved by the ethics committee of the University Medicine Greifswald and in full compliance with ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors take full responsibility for the accuracy, interpretation, and integrity of the content presented in this research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"13382"}}