Public health authorities in the United States and elsewhere around the world have worked tirelessly to spread the word about the devastating health consequences of smoking, which can lead to cancer, cardiovascular disease and serious respiratory illness. What many smokers may not realize is that their habit also may be keeping them from getting a good night's sleep.
Stimulant Effect
In an article in the February 2008 issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians, a researcher cited the stimulant effect of nicotine as a factor making it difficult to fall asleep. Naresh M. Punjabi of the Johns Hopkins University School of Medicine, leader of a study on the effects of smoking on sleep, explained how the study compared the sleep habits of 40 smokers with those of 40 nonsmokers. Pains were taken to find smokers who were free of other health conditions and not taking any medications that might interfere with their sleep.
Unlike previous studies that have relied largely on subjective measures of sleep and sleep quality, the Johns Hopkins study used polysomnographic equipment to record and quantify the biophysiological changes experienced by smokers and nonsmokers during sleep. Although significant differences were noted in sleep patterns between the two groups, the most pronounced difference came at the onset of sleep, lending credence to the premise that nicotine's stimulant effects make it more difficult for smokers to quickly attain a deep and restful level of sleep.
Mini-Withdrawal
Another factor believed to affect the quality of sleep among smokers is the effects of the mini-withdrawal that occurs when smokers temporarily stop smoking and go to bed. While the drop in levels of nicotine in the system may not be enough to prevent sleep, it appears to compromise the quality of that sleep. In his report on the Johns Hopkins study, Dr. Punjabi wrote that "by understanding the temporal effects of nicotine on sleep, we may be able to better tailor nicotine replacement to minimize the withdrawal effects that smokers experience, particularly during sleep."
Sleep Apnea
Sleep apnea, a sleeping disorder characterized by abnormal pauses in breathing or extremely shallow breathing during sleep, is exacerbated by smoking, according to Ralph A. Pascualy, author of "Snoring and Sleep Apnea." Smoking reduces the amount of oxygen in the blood and often causes swelling in the lining of the airways, which causes obstructive apnea, according to Pascualy. He strongly urges people with sleep apnea to quit smoking to avoid further complicating their condition.
Quitting and Insomnia
Just as smokers can experience the effects of withdrawal while sleeping, people who quit smoking altogether may find that one of the temporary side effects is insomnia. Taking the broadest possible view, it's a relatively small price to pay for all the other health benefits that quitting will bring. However, not getting a good night's sleep can add to the overall feelings of discomfort that accompany smoking cessation. Quit Tobacco, a Defense Department initiative that targets smokers in military service, offers some suggestions to minimize the effects of withdrawal on sleeping. Nicotine replacement medications -- lozenges, gum, patches and nasal spray -- can get you through the roughest patch in the early days of quitting. Deep-breathing exercises, done throughout the day, can keep you relaxed and pave the way for a good night's sleep. Avoid watching TV, reading or otherwise stimulating your brain just before bedtime, as that stimulation may make it difficult to fall asleep.
References
- "CHEST;" Power Spectral Analysis of EEG Activity During Sleep in Cigarette Smokers; Lin Zhang et al.; February 2008
- "Snoring and Sleep Apnea: Sleep Well, Feel Better;" Ralph A. Pascualy; 2008
- Quit Tobacco: Nicotine Withdrawal Symptoms: What to Expect When You Quit
- NCHS Health & Stats: Sleep Duration as a Correlate of Smoking
- Centers for Disease Control and Prevention: Smoking & Tobacco Use: Health Effects of Cigarette Smoking
- Smokefree.gov: Quit Smoking Today!
