Sleep and Smoking

According to the National Center for Health Statistics, 21% of adults in the U.S. are active cigarette smokers. This group of smokers also sleeps less than six hours a night – not enough for an average adult (ref: Schoenborn & Adams, 2006). Smokers believe that they need the cigarette puff to stay calm but actually what they are trying to do is overcome the withdrawal of nicotine.  Because of this believe, they think that smoking should ease them into a good night sleep- but that is quite wrong.

Cigarettes contain the chemical nicotine which influences neurotransmitters in the brain and affect sleep negatively. Nicotine is a stimulant and its effect lingers into the early part of sleep and causes the release of brain chemicals such as dopamine and norepinephrine that are linked to wakefulness.  If you are trying to sleep, nicotine will disrupt the quality of sleep (not to mention other problems- heart disease, stroke and cancer). Even the withdrawal effect from nicotine causes sleep problems which is in turn contributes to the craving of smoking- a vicious cycle. Also, smokers have weaker lungs and are more likely to cough, which further disrupt their sleep.

Scientists have been able to measure the effect of smoking on the quality of sleep in smokers by studying their brain wave activity through the EEG (electroencephalogram). A study from John Hopkins University in 2008 found that smokers spend more time in light sleep and less in deep sleep compared to their nonsmoking counterparts and that 22% of the smokers in this study reported unrefreshed and nonrestful sleep versus 5% of the nonsmokers (ref: Zhang L).

Smoking has far reaching effect on sleep quality. A twin study from Finland reveals evidence for a possible link between tobacco use and bruxism (teeth grinding during sleep) among middle-aged adults (ref: Rintakoski K).  Sleep deprivation increases smoking frequency in those who are smokers because that is how they overcome their sleepiness (re: Hamidociv A). Second hand smoking also affects sleep. Pregnant women who smoke put their babies are at risk of sleep problems. If you have a child with asthma, second hand smoking will likely make it more difficult for your child to fall asleep at night and therefore be sleepy during the day (ref: Yolton K).

Smoking inflames your nasal passages and throat tissues making them swell. It is a risk for developing obstructive sleep apnea syndrome and snoring. According to one study, people who were actively smoking were at greater risk for obstructive sleep apnea/hypopneas syndrome and snoring than nonsmokers, and those who smoked heavily had the greatest risk for sleep apnea. Good news is that those who quit smoking in the past did not have that risk (ref: Wetter DW). Even more alarming, smoking and sleep apnea have an additive effect on the risk of heart disease with those who have severe sleep apnea and smoke are at a greater risk for heart disease than individuals who do not smoke but still had a mild-moderate sleep apnea (ref: Lavie L).

Tips on improving sleep and possibly giving up smoking:

  • To protect your health, please give up smoking all together.
  • If you still want to smoke, avoid smoking in the evening and later hours to reduce its effect on sleep
  • Avoid sleep deprivation, reduce your stress level, eat healthy and exercise as means to reduce your craving for cigarettes.
  • Remember, to quit smoking, it takes an emotional and physical decision.
  • Attempt more than one technique to quit smoking: Medications, support group, counseling, hypnosis, acupuncture, chewing gum etc. According to the American Cancer Society, it may take more than 10 tries to quit before an individual can stick to it.
  • Be prepared and have a plan for the withdrawal symptoms which typically last less than 1 week: Restlessness, agitation, insomnia, anxiety, dizziness, poor concentration and irritability. Nicotine replacement through patches or gums can help during the withdrawal phase.
  • When the sudden urges arrive, have a plan: Exercise, go for a walk, call a friend or listen to relaxing music or rock and roll- whatever works for you. Remember that many smokers did so out of habit and boredoms- try to avoid such situations. Avoid being in places and around people who smoke.
  • Focus on the outcome: When you are smoke-free, you will have healthier lungs,  heart and brain; you will sleep better and breathe better. Your children and family are not exposed to second hand smoking.
  • There is free telephone counseling service that helps those who quit smoking. They are based in all 50 states and offer their help.

References:

  • Rintakoski K, Ahlberg J, Hublin C, Broms U, Madden PA, Könönen M, Koskenvuo M, Lobbezoo F, Kaprio J. Bruxism is associated with nicotine dependence: a nationwide Finnish twin cohort study. Nicotine Tob Res. 2010 Dec;12(12):1254-60. Epub 2010 Nov 1.
  • Hamidovic A, de Wit H. Sleep deprivation increases cigarette smoking. Pharmacol Biochem Behav. 2009 Sep;93(3):263-9. Epub 2008 Dec 16.
  • Zhang L, Samet J, Caffo B, Bankman I, Punjabi NM. Chest. 2008 Feb;133(2):427-32. Epub 2007 Oct 9. Power spectral analysis of EEG activity during sleep in cigarette smokers.
  • Wetter DW, Young TB, Bidwell TR, Badr MS, Palta M. Smoking as a risk factor for sleep-disordered breathing.  Arch Intern Med. 1994 Oct 10;154(19):2219-24.
  • Yolton K, Xu Y, Khoury J, Succop P, Lanphear B, Beebe DW, Owens J. Associations between secondhand smoke exposure and sleep patterns in children. Pediatrics. 2010 Feb;125(2):e261-8. Epub 2010 Jan 18.
  • Lavie L, Lavie P.Smoking interacts with sleep apnea to increase cardiovascular risk.  Sleep Med. 2008 Mar;9(3):247-53. Epub 2007 May 21.