According to 2010 paper published in "Sleep Medicine Reviews," smoking is the one behavior posing the greatest health risk to society. Smoking, quitting smoking, and withdrawal treatments all affect daytime alertness and nighttime sleep. They also affect the prevalence of sleep disorders. A 2006 report in "Revue des Maladies Respiratoires" indicates that the negative changes in sleep quality associated with smoking cessation is the most common reason for smoking relapse. While such changes are often idiosyncratic, a clear pattern is evident.
Daytime Alertness
A 1994 study described in the journal "Chest" tested the effects of smoking cessation on daytime sleepiness. Participants were forced to quit smoking for one week. Results indicated that the subjects were more sleepy in the daytime hours. They were also more irritable. Brain wave recordings showed that these effects were mediated by changes in nighttime sleep. The subjects woke up more often during nicotine withdrawal. These results suggest that quitting smoking reduces nighttime sleep quality, and that it impacts daytime alertness and mood.
Nighttime Sleep
Quitting smoking also changes the structure of sleep. These changes include alterations in Stage 2, Stage 3, and REM sleep. A 2007 investigation in "Nicotine & Tobacco Research" evaluated the long-term changes caused by nicotine withdrawal. Following one year of abstinence, patients continued to show altered sleep patterns. Most notable of these changes was a decrease in the time taken to reach REM sleep. A shortened REM latency is a symptom of depression. In fact, psychological tests revealed that quitting smoking increased depression ratings. These data indicate that smoking cessation may trigger depressive disorders.
Sleep Disorders
Smoking cessation leads to symptoms of nicotine withdrawal. These symptoms can be effectively managed by medications like bupropion. However, that antidepressant drug may cause sleep disorders during smoking withdrawal. A 2003 case study described in "Addiction Biology" shows that the intake of bupropion while quitting smoking caused sleep walking. According to a 2009 review in the journal "Drugs," the medication varenicline is effective for smoking cessation without this side effect. Unfortunately, varenicline has been associated with suicidal tendencies. Thus more data are needed before either drug can be recommended as a safe and effective treatment strategy.
Sleep Initiation
Insomnia is a commonly reported consequence of quitting smoking. This problem is made worse by the fact that nicotine patches also make it more difficult to initiate sleep. A 2006 study in "Physiology & Behavior" investigated the effects of transdermal patches in people who were trying to quit smoking. The patch increased the time spent awake and the number of nighttime arousals. It also decreased the percentage of REM sleep, yet dreams were more vivid during withdrawal. These findings reveal the need for better ways to aid smoking cessation.
References
- "Sleep Medicine Reviews"; Effects of Nicotine on Sleep during Consumption, Withdrawal and Replacement Therapy; A. Jaehne et al.; October 2009
- "Revue des Maladies Respiratoires"; Cigarette Smoking and Sleep Disturbance; M. Underner et al.; June 2006
- "Chest"; Effects of Abstinence from Smoking on Sleep and Daytime Sleepiness; G. L. Prosise et al.; April 1994
- "Nicotine & Tobacco Research"; Long-Term Changes in Sleep and Depressive Symptoms of Smokers in Abstinence; A. Moreno-Coutino et al; March 2007
- "Addiction Biology"; Bupropion-Induced Somnambulism; Y. Khazaal et al.; September 2003
