Sleep Duration and Efficiency Associated With Better Functional Exercise Capacity in Black Smokers at Risk for COPD

Andrew J. Gangemi, Aditi Satti, Massa Zantah, Rachel Blair, Benjamin Brewer, Grace Ma, Michael A. Grandner, Adam Davey, Gerard J. Criner, Freda Patterson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Black smokers have earlier development of lung disease as well as poorer sleep health than whites. Research Question: In a sample of black smokers, to what extent does sleep health modify the association between smoking level and functional exercise capacity? Design and Methods: Cross-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. Results: The 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. Interpretation: Higher SE and, to a lesser extent, longer TST, in black adults who smoke ≥ 10 cpd is associated with better 6MWT performance. Clinical Trial Registration:; No.: NCT03534076; URL:

Original languageEnglish (US)
Pages (from-to)1680-1688
Number of pages9
Issue number4
StatePublished - Oct 2020


  • 6-min walk test
  • black adults
  • sleep health
  • smoking

ASJC Scopus subject areas

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


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