• Andrew J Gangemi, Aditi Satti, Massa Zantah, Rachel Blair, Benjamin Brewer, Grace Ma, Michael A Grandner, Adam Davey, Gerard J Criner, and Freda Patterson.
• Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA.
• Chest. 2020 Oct 1; 158 (4): 168016881680-1688.

BackgroundBlack smokers have earlier development of lung disease as well as poorer sleep health than whites.Research QuestionIn a sample of black smokers, to what extent does sleep health modify the association between smoking level and functional exercise capacity?Design And MethodsCross-sectional data from 209 black smokers (≥ 1 cigarette in last month), aged 40 to 65 years with no evidence of sleep-disordered breathing (apnea-hypopnea index < 15) or severe COPD (FEV1 > 50%), were used for the current study. Self-reported smoking rate, objectively measured sleep efficiency (SE), total sleep time (TST), and the 6-min walk test (6MWT) for functional exercise capacity were the key assessments.ResultsThe mean age was 54.8 years (SD, 5.96), and mean cigarettes smoked per day (cpd) was 8.71 (SD, 6.78). Mean SE was 69.9% (SD, 12.3%), and mean TST was 307.99 min (SD 92.2). In adjusted linear regression models of the 6MWT (meters), TST (slope estimate, -0.14; P = .14) and SE (slope estimate, -1.0; P = .19) were negatively associated with 6MWT. The smoking rate × SE interaction was highly significant (slope estimate, 0.18; P = .007) such that in individuals who smoked ≥ 10 cpd, every additional percentage of SE garnered an additional distance of 0.83 to 6.62 m. Similarly, the smoking rate × TST interaction was significant (slope estimate, 0.019; P = .03) such that in smokers who smoked ≥ 10 cpd, every additional minute of TST garnered an additional distance of 0.04 to 0.60 m.InterpretationHigher SE and, to a lesser extent, longer TST, in black adults who smoke ≥ 10 cpd is associated with better 6MWT performance.Clinical Trial RegistrationClinicalTrials.gov; No.: NCT03534076; URL: www.clinicaltrials.gov.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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