0683 Smoking and Perceived Stress: Examining Associations with Subjective Symptoms of Obstructive Sleep Apnea through Parallel Mediation Analyses

Abstract Introduction Cigarette smoking is known to have a negative effect on individuals’ sleep quality. Specifically, evidence shows that smoking can exacerbate sleep disorders such as obstructive sleep apnea (OSA) by increasing irritation and inflammation of the upper respiratory conducts. Furthermore, previous research highlights a complex bidirectional positive association between cigarette smoking and perceived stress. Sleep quality may be an important aspect intervening in the association between smoking and perceived stress, given that individuals who report high stress also report more sleeping issues and increased risk for OSA. Further research is needed to elucidate the impact of smoking and OSA on perceived stress. Methods The present cross-sectional survey of N=459 (75.8% female; 60.3% non-Hispanic White) current smokers and non-smokers investigated the associations between smoking status and perceived stress through the indirect effects of subjective OSA symptoms. A parallel mediation analysis using PROCESS Macro Model 4 was conducted with three mediators: risk for OSA based on subjective symptoms (assessed using the STOP portion of the STOP-BANG questionnaire), average sleep propensity (evaluated using the Epworth Sleepiness Scale), and overall subjective sleep quality (assessed with the Pittsburgh Sleep Quality Index). Race, sex, employment, and income were added to the model as covariates. Results Analyses supported a significant indirect effect of risk for OSA based on subjective symptoms (B = -0.55, 95% CI [-1.07, -0.09]) and overall subjective sleep quality (B = -1.39, 95% CI [-2.16, -0.74]) on the relationship between smoking status and perceived stress. However, average sleep propensity was not found to mediate this association (B = -0.09, 95% CI [-0.45, 0.21]). The direct effect of smoking status on perceived stress was also not statistically significant (B = 0.06, t = 0.09, p = 0.93). Conclusion Findings illustrate that smokers tend to be at greater risk for OSA and overall report worse sleep quality, which in turn increases their reported levels of perceived stress. Further research is necessary to understand possible demographics-based differences behind these findings as well as potential clinical implications. Support (If Any) This project was financially supported by the National Institute of Drug Abuse (R01DA046096-02S1).