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April 10, 1995

Cigarette Smoking and Sleep Disturbance

Author Affiliations

From the Pulmonary Division, Department of Medicine (Dr Phillips), and the Educational Psychology Division, College of Education (Dr Danner), University of Kentucky, Lexington.

Arch Intern Med. 1995;155(7):734-737. doi:10.1001/archinte.1995.00430070088011

Background:  Individuals with sleep complaints often exhibit unhealthy lifestyles, including obesity, excessive alcohol use, lack of physical exercise, and cigarette smoking. We sought to explore the relationship between cigarette smoking, poor sleep habits, and sleep complaints. Several lines of evidence suggest a relationship between cigarette smoking and sleep disturbance, including the effects of nicotine and nicotine withdrawal on sleep, a tendency for nonsmokers to be more alert in the morning, an association between cigarette smoking and snoring, and a tendency for individuals who engage in one unhealthy behavior also to engage in others.

Method:  A total of 484 individuals aged 14 to 84 years completed a comprehensive sleep and health questionnaire. There were 99 high school students from grades 9 through 12 (45 boys and 54 girls, of whom 38 [38%] were smokers), who completed an in-class survey. In addition, 385 adults aged 20 to 84 years (122 men and 263 women, of whom 77 [20%] were smokers) from a random sample of 1000 completed a mail survey. The effects of age and smoking status on sleep, health, and daytime function were assessed by multivariate analysis of variance.

Results:  Cigarette smokers were significantly more likely than nonsmokers to report problems going to sleep, problems staying asleep, daytime sleepiness, minor accidents, depression, and high daily caffeine intake.

Conclusion:  Individuals with sleep complaints should be queried about tobacco use. Those who are smokers should be advised that there is a relationship between cigarette smoking and sleep disturbance.(Arch Intern Med. 1995;155:734-737)