Does nicotine keep you up

The Chemistry of Caffeine, Nicotine, and Sleep

As we pack more and more into our busy schedules, something’s gotta give. More often than not, that something is sleep.

The U.S. Centers for Disease Control and Prevention estimates that 50 to 70 million Americans are chronically sleep-deprived. The reasons are just what you would expect — too many responsibilities at work, at home, excessive TV watching, and Web surfing. But there are two other culprits that may be to blame: caffeine and nicotine.

Cruising All Day With Caffeine

With a coffee shop seemingly on every street corner, it’s tempting to turn to coffee to stay alert. In fact, according to the National Sleep Foundation, caffeine has been called the most popular drug in the world. And it’s not just in coffee. Caffeine can be found in everything from tea and chocolate to certain soft drinks and medications.

One reason it’s so popular is because, when we’re feeling sleepy, caffeine can temporarily increase alertness by pumping up adrenaline production and interfering with sleep-inducing chemicals. Not only that, it’s fast. It can be absorbed quickly — within 15 minutes — as it gets into the bloodstream through the stomach and small intestine.

Is Caffeine Keeping You Up?

But the news is not all good. “Caffeine is a stimulant and therefore impedes sleep,” says David C. Brodner, MD, medical director of the Center for Sleep, Allergy, and Sinus Wellness in Boynton Beach, Fla.

It stays in the body for a relatively long period of time, taking six hours for just one half of the caffeine to be eliminated. Too much caffeine may cause insomnia, which can manifest itself as trouble falling asleep or staying asleep. A “normal” amount of caffeine consumption is about 250 milligrams per day, or the equivalent of three eight-ounce cups of coffee. Consumption becomes excessive at 500 mg a day, or six or more eight-ounce cups of coffee. Excessive caffeine can cause frequent urination — and multiple trips to the bathroom during the night.

Ironically, not only can too much caffeine cause sleep problems, but so can cutting down on caffeine intake — this can temporarily result in sleep issues while the body goes through withdrawal.

“Like withdrawal from any addictive substance, sleep will be affected by the increased autonomic response — jitteriness, nausea, increased heart rate, headaches, and irritability,” says Dr. Brodner, adding, “all completely opposite from the relaxed serenity required for good quality sleep.”

As the body adjusts to less caffeine, these symptoms should subside.

Nicotine May Cause Less Sleep

Nicotine is also a stimulant, and nicotine side effects can cause insomnia and withdrawal symptoms similar to caffeine. Smoking may also create other sleep disturbances. Research has shown that smokers spend more time sleeping lightly and less time in deep sleep than non-smokers. The biggest differences are found early in the night’s sleep, corresponding to the time when the highest levels of nicotine are present in a smoker’s blood. Scientists also speculate smokers may have withdrawal symptoms closer to morning, and that could contribute to sleep problems as well.

There’s no doubt caffeine and nicotine can cause insomnia and interfere with restorative sleep. Try cutting back on your consumption and you might find yourself sleeping easier.

How Does Smoking Affect Sleep?

Whether you’re smoking cigars or cigarettes, nicotine is no friend to your sleep. Smoking before bed is a terrible idea for several reasons.

Cigarettes contain nicotine, which is a stimulant. Even though people smoke in order to relax before bed, they’re actually telling their body to do just the opposite. Nicotine increases your heart rate and alertness, so you feel more awake when you’re trying to fall asleep.

Plus, nicotine is addictive and fast-acting. It enters your bloodstream and your brain within a few seconds. Unfortunately, within a matter of hours, it starts leaving the body. If you are addicted to nicotine, as most smokers are, you’re likely to experience withdrawal symptoms as you sleep – to the extent that your brain will wake you up to get more nicotine, and thus interrupt your slumber.

The less sleep you get, the more sleep deprived you become. So you can add the dangers of sleep deprivation to the long list of health risks you’ve accumulated from smoking. Sleep deprivation worsens your mood, ability to focus, and cognitive performance the following day. If your sleep deprivation becomes chronic, you can expect more serious long-term health risks like cancer and sleep disorders.

Outside of its impact on your sleep, smoking a cigarette in bed is especially dangerous because you can fall asleep while it’s still lit and accidentally burn yourself or your bedroom.

Sleep architecture changes

Regular smoking actually changes your sleep architecture. Sleep architecture refers to the cycle of sleep stages you experience during sleep – including light sleep, deep sleep, and REM sleep. Spending sufficient time in all of these is critical to having a restful night of good sleep.

Multiple studies have found smoking has negative effects on overall sleep time, as well as time spent within each sleep stage.

  • Every cigarette smoked equates to 1.2 minutes of lost sleep.
  • Regular smokers take longer to fall asleep, spend less time asleep overall, and experience less slow-wave deep sleep than nonsmokers.
  • Smokers have shorter sleep times by 33 minutes, and also spent nearly 4% less time in REM sleep.
  • Smokers are 4 times likelier to report feeling unrefreshed after a night’s sleep than nonsmokers, probably due to the fact they spend more time in light sleep.

A 2013 study of mice showed that smoking tobacco can disrupt the circadian clock. The more the exposure to tobacco, the worse the disruption. In addition to poor sleep, the likelihood of depression, anxiety or another mood disorder also increased.

Some studies have shown that although sleep issues typically go away once someone quits smoking, they won’t ever sleep as well as their never-smoking peers.

Smoking is tied to two common sleep problems: insomnia and sleep-disordered breathing, such as snoring or sleep apnea.

Insomnia

Because nicotine is stimulating, it can wake your mind and body and cause sleep-onset insomnia, or difficulty falling asleep.

Depending on your level of addiction, awakening during the night due to withdrawal can lead to sleep-maintenance insomnia.

Sleep-disordered breathing

Sleep-disordered breathing is any kind of abnormal breathing during sleep. Snoring and sleep apnea are two types of sleep-disordered breathing

Snoring is noisy breathing during sleep that occurs when the sleeper’s upper airway is obstructed. Snoring is associated with increased risks of heart disease and diabetes, as well as the daytime fatigue associated with sleep deprivation.

Obstructive sleep apnea (OSA) develops due to blockage or obstruction of the tissues and nasal airways. A person with OSA will literally stop breathing momentarily during sleep, causing their brain to rouse them just enough to start breathing again. They may not consciously wake up, but their sleep cycle gets disrupted all the same – often resulting in insomnia and sleep deprivation.

Smoking is tied to OSA because some of the material in cigarettes cause the throat and nasal tissues to swell, resulting in the blockage that causes apneic episodes. In fact, people who smoke are 2.5 times more likely to have OSA.

If you share your bed with a child or partner, the irritants from your second-hand smoke can lead them to have OSA, too.

Yes. While you avoid some of the health risks of smoking by switching to e-cigarettes, vaping still delivers nicotine to your body and interferes with sleep.

As long as there is nicotine in your e-liquid, it will affect your sleep. You’re still exposing your body to nicotine.

Nicotine withdrawal and sleep

Some people experience extreme fatigue once they quit smoking, especially if they go cold turkey.

Our brains rely on a neurotransmitter called acetylcholine to keep us awake and alert. When you smoke, nicotine mimics acetylcholine by binding to the same receptors in the brain. As a result, smokers feel awake and alert (the way they would with acetylcholine, but it’s actually due to the nicotine levels in their brain). If you stop smoking instantly, your brain suddenly has no acetylcholine or nicotine to rely on, and you feel extremely drowsy.

Fortunately, the brain will normalize your acetylcholine levels over time.

Why Alcohol, Nicotine Disrupt Your Sleep More Than Coffee

Share on PinterestExperts say drinking coffee at night probably won’t affect your sleep pattern that much. Getty Images

  • Researchers say nicotine and alcohol before bedtime can have a negative impact on the quantity and quality of sleep.
  • Experts say coffee and other caffeinated beverages don’t significantly affect sleep patterns for most people.
  • Doctors are being urged to tell people with sleep difficulties to avoid smoking or drinking alcohol in the hours before they go to sleep

We could all use more sleep — or at least better quality sleep.

And people who smoke cigarettes or have an evening drink may be cheating themselves out of some important deep slumber.

New research published in the journal Sleep suggests that to get a good night’s rest, you should cut back on nicotine and alcohol, and not necessarily caffeine, four hours before bed.

They say that could help improve the quality and quantity of your sleep.

A study led by a researcher at Florida Atlantic University (FAU) — with help from Brigham and Women’s Hospital, Harvard University, Emory University, the University of Mississippi Medical Center, and the National Institutes of Health — focused on the evening consumption of alcohol, caffeine, and nicotine among 785 African-Americans over a combined 5,164 days.

Researchers measured their corresponding sleep using wristwatch-like sensors and participants’ daily entries into sleep diaries.

Researchers say their data showed that people who used nicotine and alcohol within four hours of going to bed felt the largest impact on their sleep cycle, even when controlling for age, gender, stress, and other factors.

Nicotine was particularly harsh on people with insomnia. Using nicotine at night resulted in a more than 40-minute reduction in overall sleep.

The study authors note that because nicotine was the most commonly used substance that kept people up at night, it was yet another reason for people to quit this unhealthy habit. That includes smoking, vaping, dipping, and all the other ways nicotine can be ingested.

One important detail of the study is that it focused on African Americans who didn’t think they had problems sleeping at night and followed them through different points in their daily routines, from waking up for school to waking up for work.

“African Americans have been underrepresented in studies examining the associations of nicotine, alcohol, and caffeine use on sleep,” Christine E. Spadola, PhD, lead author of the study and an assistant professor in FAU’s Phyllis and Harvey Sandler School of Social Work, said in a press release. “This is especially significant because African Americans are more likely to experience short sleep duration and fragmented sleep compared to non-Hispanic whites as well as more deleterious health consequences associated with inadequate sleep than other racial or ethnic groups.”

The study authors also note their findings support recommending that doctors and others in the healthcare field to advise people who complain about sleep difficulties to limit nicotine and alcohol consumption before bedtime.

The researchers, however, found little correlation between coffee consumption within four hours of going to bed and sleep difficulties.

Researchers did warn that dosing, sensitivity, and tolerance weren’t measured and “can play an important role in the association between caffeine use and sleep.”

Basically, the study suggests that it’s that late-night smoke or vape and the extra glass of wine after dinner that are keeping you up, not necessarily that 4 p.m. cup of coffee to get you through those last hours of work.

We all have trouble sleeping from time to time. But you can make it easier to get a good night’s sleep every night with these simple steps.

1. Cut caffeine. Simply put, caffeine can keep you awake. It can stay in your body longer than you might think — up to about 14 hours. So if you drink a cup of coffee at noon and are still awake at midnight, that might be the reason. Cutting out caffeine at least four to six hours before bedtime can help you fall asleep easier. If you have already had too much caffeine, try eating some carbohydrates like bread or crackers to help reduce the effects.

2. Drink alcohol in moderation. Alcohol may initially help you fall asleep, but as your body clears it from your system, it can also cause symptoms that disturb sleep, like nightmares, sweats and headache. Drink one glass of water for every alcoholic beverage consumed to try to reduce these symptoms.

3. Relax before bedtime. Stress not only makes you miserable, it wreaks havoc on your sleep. Develop some kind of pre-sleep ritual to break the connection between all the day’s stress and bedtime. These rituals can be as short as 10 minutes or as long as an hour. Some people find relief in making a list of all the stressors of the day, along with a plan to deal with them. This can act as “closure” to the day. Combining this with a period of relaxation — perhaps by reading something light, meditating, aromatherapy, light stretching, or taking a hot bath — can also help you get better sleep. And don’t look at the clock! That “tick-tock” will just tick you off.

4. Exercise at the right time for you. Regular exercise can even help you get a good night’s sleep. The timing and intensity of exercise seems to play a key role in its effects on sleep. If you are the type of person who gets energized or becomes more alert after exercise, it may be best not to exercise in the evening. Regular exercise in the morning even can help relieve insomnia, according to a recent study.

5. Keep your bedroom quiet, dark and comfortable. For many people, even the slightest noise or light can disturb sleep — like the purring of a cat or the light from your laptop or TV. Use earplugs, window blinds or curtains and an electric blanket or air conditioner — everything possible to create an ideal sleep environment. And don’t use the overhead light if you need to get up at night; use a small night-light instead. Ideal room temperatures for sleeping are between 68 and 72 degrees. Temperatures above 75 or below about 54 can disrupt sleep.

6. Eat right, sleep tight. Try not to go to bed hungry, but avoid heavy meals before bedtime. An over-full belly can keep you up. However, some foods can help. Milk contains tryptophan, which is a sleep-promoting substance. Other foods that help promote sleep include tuna, halibut, pumpkin, artichokes, avocados, almonds, eggs, bok choy, peaches, walnuts, apricots, oats, asparagus, potatoes, buckwheat and bananas. Also, try not to drink anything after 8 p.m. This can keep you from getting up to use the bathroom during the night.

7. Restrict nicotine. Having a smoke before bed — although it feels relaxing — actually puts a stimulant into your bloodstream. The effects of nicotine are similar to those of caffeine. Nicotine can keep you up and awaken you at night; it can stay in your body as long as 14 hours. It should be avoided particularly near bedtime and if you wake up in the middle of the night.

8. Avoid napping. Napping can only make matters worse if you usually have problems falling asleep. If you do nap, keep it short. A brief 15-20-minute snooze about eight hours after you get up in the morning can actually be rejuvenating.

9. Keep pets off the bed. Does your pet sleep with you? This, too, may cause you to awaken during the night, either from allergies or pet movements. Fido and Fluffy might be better off on the floor than on your sheets.

10. Avoid watching TV, eating, and discussing emotional issues in bed. The bed should be used for sleep and sex only. If not, you can end up associating the bed with distracting activities that could make it difficult for you to fall asleep.

About the Expert: Michael J. Breus, Ph.D., is a Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine. His first book, “GOOD NIGHT: The Sleep Doctor’s 4-Week Program to Better Sleep and Better Health” (Dutton/Penguin), an Amazon Top 100 Best Seller, has been met with rave reviews and continues to change the lives of readers. Dr. Breus has been interviewed on CNN, Oprah, The View, Dr. Oz and The Doctors. In August 2008, Dr. Breus debuted his show “As Recommended by The Sleep Doctor,” on the Home Shopping Network (HSN). For additional information, visit www.thesleepdoctor.com.

Smoking may make your sleep suffer

If you smoke, you get less sleep and a “lower quality of rest” than non-smokers do, according to today’s Daily Mail.

The links between smoking and serious, potentially fatal conditions (such as lung cancer and heart disease) are well known. But this headline stems from a recent study suggesting that those of us who enjoy a puff may have sleepless nights too.

The news is based on the results of a German case-control study that recruited smokers and non-smokers from the general population. The researchers asked them to complete a questionnaire on several sleep-related factors, such as how long it took them to fall asleep after going to bed.

The researchers found that current smokers were more likely to report poor sleep quality, even after certain factors that could explain the link were accounted for, such as stress and alcohol consumption.

The researchers also found that, among smokers, more nicotine dependence and smoking intensity were associated with less sleep each night.

They speculated that there could be a direct biological cause and effect relationship between cigarette smoking and poor sleep, possibly due to the stimulant effects of cigarette ingredients, such as nicotine.

But the current study can’t prove this theory, as there are other possible explanations for the findings, including other lifestyle choices not accounted for (such as a poor diet, which has previously been linked to poor sleep). Furthermore, it is not clear whether poor sleep was likely to increase the amount the participants smoked, or whether smoking decreased their sleep quality, or both.

What the study does suggest is that improved sleep may be just one of a range of important health benefits that come if you stop smoking.

Where did the story come from?

The study was carried out by researchers from different research centres and universities in Germany. It was funded by the German Research Foundation.

The study was published in the peer-reviewed journal Addiction Biology.

The Daily Mail reported the results of this study accurately.

What kind of research was this?

This was a case-control study that recruited smokers and non-smokers randomly from the general population. It aimed to determine whether smoking has an effect on sleep quality in people without a history of psychiatric disorders, as this may skew any association seen.

It then aimed to determine whether, among smokers, any of the following factors have an influence on the different aspects of sleep quality:

  • the degree of nicotine dependence
  • the number of cigarettes smoked each day
  • smoking urges
  • blood cotinine levels
  • exhaled carbon monoxide (CO) (markers for exposure to tobacco smoke)

This was a well-designed trial, but due to the study design it can’t show whether smoking causes sleep disturbances. This is because there are other factors that could explain any link seen. For example, smokers could watch more TV or have a poorer diet, both of which are thought to affect sleep.

Furthermore, we don’t know whether poor sleep increases the amounts people smoke, or whether smoking decreases sleep quality (this type of uncertainty is known as a temporal bias, which is where we are unsure whether “A leads to B” or vice versa).

A randomised controlled trial could perhaps test whether smoking is responsible for poor sleep quality, although this is highly unlikely to be performed for ethical reasons due to the other, more serious harms associated with smoking.

What did the research involve?

The researchers recruited 1,071 current smokers (defined as smoking at least seven cigarettes a week) and 1,243 people who had never smoked (or who only had smoked a maximum of 100 cigarettes in their lifetime), from the general population in Germany. To be included in the study people had to be aged between 18 and 65 years old, and to be free from alcohol, substance use and psychiatric disorders. The researchers evaluated sleep quality in smokers and non-smokers by asking them to complete a questionnaire that collected data on:

  • sleep quality
  • sleep latency (the amount of time it takes to fall to sleep)
  • sleep duration
  • habitual sleep efficiency (the proportion of time actually spent asleep while in bed)
  • sleep disturbances
  • use of sleep medication
  • daytime dysfunction

The researchers also collected data on the level of smoking and the level of nicotine dependence that the smokers experienced. To determine the level of nicotine dependence, the smokers completed another questionnaire: the Fagerström Test of Nicotine Dependence. The smokers were also asked how many cigarettes they smoked daily and for how long they had smoked (to determine their lifetime consumption).

Plasma levels of cotinine (a substance that is formed when nicotine is broken down inside the body) and levels of exhaled carbon monoxide (CO) were measured.

Smokers were also asked to complete the Questionnaire of Smoking Urges, which is designed to assess how frequently people experience cravings for cigarettes.

The researchers looked to see if there was an association between smoking and sleep disturbance, and whether this association was present after they had adjusted for a number of variables that may explain the differences (confounders), including:

  • age
  • sex
  • body mass index (BMI)
  • level of education
  • income
  • depression symptoms
  • anxiety
  • attention deficit hyperactivity disorder (ADHD) symptoms
  • alcohol consumption
  • perceived stress

The researchers also investigated whether the level of nicotine dependence, the number of cigarettes smoked per day, smoking urges, blood cotinine levels and exhaled CO have an influence on sleep quality and duration.

What were the basic results?

Significantly more smokers (28.1%) than non-smokers (19.1%) demonstrated overall poor sleep quality. After adjusting for potential confounders, the smokers demonstrated increased risk of disturbances on the following sleep measures:

  • Sleep latency: smokers required increased time needed to get to sleep (odds ratio 1.42).
  • Sleep duration: smokers had reduced amount of sleep per night (OR 1.98).
  • Global sleep quality: smokers had reduced sleep quality (OR 1.35).

However, smokers were at reduced risk of daytime dysfunction (known as daytime sleepiness) (OR 0.66). The researchers speculated that this may be due to the “activating properties of nicotine”.

The researchers also found that among smokers, higher degrees of nicotine dependence and intensity of smoking were associated with less sleep each night.

  • Levels of exhaled CO, number of cigarettes reportedly consumed each day and plasma cotinine levels were all associated with reduced sleep duration.
  • A high degree of nicotine dependence, high intensity of smoking urges and number of cigarettes smoked each day were associated with increased sleep latency.
  • Heavily dependent smokers suffered more sleep disturbances.
  • The number of cigarettes smoked each day was associated with poor overall sleep quality.

How did the researchers interpret the results?

The researchers concluded that this study demonstrates “an elevated prevalence of sleep disturbance in smokers compared with non-smokers in a population without lifetime history of psychiatric disorders, even after controlling for potentially relevant risk factors”.

Conclusion

This case-control study has shown that current smokers are more likely to report poor sleep quality. This was a well-designed trial but with some limitations:

  • Due to the study’s design, it can’t show whether smoking causes sleep disturbances. This is because there are other factors that could explain any link seen. For example, smokers could make other unhealthier choices, such as watching more TV or drinking more coffee than non-smokers do.
  • As the researchers didn’t follow people up over time, we don’t know which came first: whether poor sleep increased the amount the participants smoked, or whether their smoking decreased their sleep quality, or a bit of both.
  • The complex interplay of factors, including some the researchers measured such as alcohol consumption, means that this study is a first step into untangling several behaviours and their underlying causes, but at this stage seems exploratory.

Alongside all the well-proven reasons to stop smoking, improved sleeping may not be high on the list, but insomniacs who smoke could be well advised to try stopping.

Analysis by Bazian
Edited by NHS Website

Links to the headlines

Smokers get fewer hours sleep and a lower quality of rest than non-smokers, scientists claim

Daily Mail, 14 September 2012

Links to the science

Cohrs S, Rodenbeck A, Riemann D, et al.

Impaired sleep quality and sleep duration in smokers—results from the German Multicenter Study on Nicotine Dependence

Addiction Biology, Published online August 23 2012

20th January 2020 – by Rachel Davies

Filed Under: Vaping Lifestyle

The damaging effects of regular cigarettes has been well documented, which is why many smokers are making the switch from smoking to using e-cigarettes instead, and swapping out harmful tobacco for e-liquid. Smoking is extremely harmful in a variety of ways and can lead to a selection of health issues, which is the main reason why many people make a shift towards getting their nicotine hit from e-cigarettes instead.

However, some of those that do decide to make this switch may notice several changes to their lifestyle, which may affect sleep. But just exactly how does vaping affect sleep and why?

Updated: 20th Jan 2020

Does vaping affect sleep?

The short answer to this question is yes, vaping does affect sleep, especially for those who have recently made the switch from smoking. It’s a frustrating reality for some vapers, but it’s important to remember that this is only a part of the transition period, and definitely isn’t a permanent feature of your life as a vaper.

Why does vaping affect sleep?

The simple answer is that if you are making a switch from cigarettes to e-cigarettes then it’s very likely you will have selected e-liquids with nicotine. As nicotine is a stimulant it can sometimes have a similar effect as caffeine, leading to you staring up at the ceiling in the middle of the night wondering why you can’t just drop off.

The nicotine hit you get from e-cigarettes is often more potent than that which you receive from a traditional cigarette, which is why you’ll find you have an adjustment period even if you’re used to having nicotine in your system.

Related: 7 Vaping Misconceptions

Stop vaping affecting sleep

It might seem like there’s no solution to your sleepless state when you’re lying awake in the early hours of the morning but there’s no need to worry. There are a few things you can do before bed to make sure you stand a better chance of dropping off easily. First of all, switch to an e-liquid with a lower nicotine strength than the one you’re currently using. You could even switch to a nicotine free one as it gets later in the evening, which will help give you a big enough window of time to get rid of the chemical in your body before going to sleep. At Totally Wicked we have e-liquids in a range of different nicotine strengths to suit your lifestyle best. You could also try vaping less as it gets later in the day. This is a good option if you’re reluctant to buy new e-liquid.

As well as taking care with your vaping habits and the e-liquid choices you make, taking care to make sure other factors don’t affect your sleep is just as important. Avoiding too much screen time before you go to bed is also important, as the blue light emitted from electronic screens tricks your brain into thinking it’s the time to be awake, not for winding down. Other things such as drinking alcohol and caffeinated beverages can have a big effect on your sleeping schedule, as well as external factors, such as stress. However, experiencing some mild sleep disturbance when making the switch from cigarettes to e-cigs is pretty normal, and we would argue that the better health you will experience is worth a few nights of below average rest.

Was your sleep affected when you first started using e-cigarettes? Let us know your experiences in the comments section.

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  • Smoking Linked To Sleep Disturbances

    Researchers speculate that the stimulating effects of nicotine could cause smokers to experience nicotine withdrawal each night, which may contribute to disturbances in sleep.

    “It is possible that smoking has time-dependent effects across the sleep period,” said study author Naresh M. Punjabi, MD, PhD, FCCP, Johns Hopkins University School of Medicine, Baltimore, MD. “Smokers commonly experience difficulty falling asleep due to the stimulating effects of nicotine. As night evolves, withdrawal from nicotine may further contribute to sleep disturbance.”

    Dr. Punjabi and colleagues from Johns Hopkins University School of Medicine compared the sleep architecture of 40 smokers with that of a matched group of 40 nonsmokers, all of whom underwent home polysomnography. Previous studies comparing smokers and nonsmokers have primarily used subjective measures of sleep; what makes this recent study unique is the study population, the use of objective measure of sleep, and the quantitative nature of the analysis. Unlike most studies on sleep comparing smokers and nonsmokers, Dr. Punjabi’s study included smoking and nonsmoking subjects who were free of most medical comorbidities and medication use.

    “Finding smokers with no health conditions was challenging. But in order to isolate the effects of smoking on sleep architecture, we needed to remove all factors that could potentially affect sleep, in particular, coexisting medical conditions,” said Dr. Punjabi. “In the absence of several medical conditions, sleep abnormalities in smokers could then be directly associated with cigarette use.”

    An additional strength of this study was that sleep architecture was analyzed using both the conventional method of visual classification of electroencephalogram (EEG) patterns and through power spectral analysis of the EEG, which relies on a mathematical analysis of different frequencies contained within the sleep EEG.

    “Previous sleep studies have relied on visual scoring of sleep stages, which is time-consuming and subject to misclassification,” said Dr. Punjabi. “Spectral analysis allows us to more objectively classify the sleep EEG signals and helps detect subtle changes that may have been overlooked with visual scoring.”

    Visual scoring of sleep staging showed similar results between smokers and nonsmokers. However, spectral analysis showed that smokers had a lower percentage of delta power, or deep sleep, and a higher percentage of alpha power, or light sleep. When asked about sleep quality, 22.5 percent of smokers reported lack of restful sleep compared with 5.0 percent of nonsmokers. Spectral analysis also showed that the largest difference in sleep architecture occurred at the onset of sleep, which supports the premise that nicotine’s effects are strongest in the early stages of sleep and potentially decrease throughout the sleep cycle. The researchers speculate the results of their study may have significant future implications in the area of smoking cessation.

    “Many smokers have difficulty with smoking cessation partly because of the sleep disturbances as a result of nicotine withdrawal,” said Dr. Punjabi. “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.” Smokers also reported more caffeine use than nonsmokers. However, caffeine consumption was not associated with the results of the EEG spectral analysis or lack of restful sleep.

    “The long-term effects of smoking on respiratory and cardiovascular health are well-known,” said Alvin V. Thomas, Jr., MD, FCCP, and President of the ACCP. “However, this study is significant because it suggests that smokers may also be deprived of the much-needed restorative effects of sleep. This study provides yet one more reason to stop smoking or to never start.”

    Sleeprate Blog

    “I make it a rule never to smoke while I’m sleeping”.

    This was a quote from the great Mark Twain, and it may never be truer than it is today.

    As World No Tobacco Day (WNTD) approaches on May 31, 2018, we are continually reminded of the tobacco epidemic and its impact of public health, particularly in causing the death and suffering of millions of people around the world. In the U.S. alone, tobacco use is the largest preventable cause of death and disease today, causing various types of cancer, as well as heart disease, stroke, lung disease, and other health-related problems.

    The commonly-known health risks associated with tobacco are not the only ones we should be concerned with however; we should also be aware of the deep and profound effects that smoking can have on another part of your life: your sleep. Sleep is not just another part of your life; it’s a vital ingredient making up one third of human life. It’s as vital as water, air and food are. Sleep is not expendable!

    The goal of World No Tobacco Day is to encourage a 24-hour period of abstinence from all forms of tobacco consumption around the globe. The day draws much needed attention to the widespread prevalence of tobacco use and its negative health effects…not the least of which is its effect on sleep.

    The hidden dangers of a that nighttime smoke
    While many smokers like to ‘wind down’ with a smoke and calm their nerves before sleep, they likely don’t realize that the nicotine in cigarette smoke actually has the opposite effect: nicotine rushes through the body quickly, disrupting sleep and leading to nighttime problems such as insomnia and sleep-disordered breathing – among other sleep-related problems. While most people feel more relaxed after smoking, the nicotine in cigarettes and tobacco actually raises both your heart rate and alertness…two things you definitely don’t want before trying to get the restful night of sleep you deserve.

    Smoking before bedtime is an unhealthy habit that can’t be ignored. The most noticeable effect of smoking on sleep is the reduction of time that people spend in deep sleep, leading to a reduced feeling of waking up well-rested in the morning. In 2008, the journal “Chest” reported that chronic smokers spend more time in light sleep, especially during the early parts of the night. Additionally, Dr. Ron Kramer of the American Academy of Sleep Medicine conducted another survey about sleep health, which revealed that smokers often get less than six hours sleep, and that they’re not well-rested in general.

    Smoking is a risk factor for another serious disorder: sleep apnea. Smoking increases inflammation and fluid retention in your upper airway, which leads to swelling in your nose and throat walls, causing a narrowing of your airways. The narrow passages are more prone to repeated collapse during sleep, causing not only airway obstruction, but also stopped breathing and hypoxia, which is a lowering of the blood oxygen levels. Resuming efficient respiration requires resuming wakefulness for a few seconds, causing disruptions in sleep that have many dangerous effects – including health problems such as strokes, heart disease, cancer, decreased cognitive functioning, and more.

    The power of sleep
    As the former English dramatist Thomas Dekker once said, “Sleep is the golden chain that ties health and our bodies together”. Our sleep affects every aspect of our lives – from fitness to productivity to appearance. Sleep not only recharges your body and mind, but also boosts your energy level and enhances your mood. It gives you the ability to think more clearly, resolve problems, and be more productive at work and in any other aspect of your day-to-day life. Lack of sleep – on the other hand – depresses your immune system, and is associated with a greater risk for high blood pressure, diabetes, obesity, depression, anxiety and more.

    Once you add smoking to that mix, you’ve got a dangerous combination of actually feeling more and more awake when you’re trying to go to sleep. Smoking regularly wreaks havoc on your body’s natural sleep routine, and some of that damage just can’t be undone. Getting adequate, healthy sleep provides you a powerful tool to help reach your goals and lead a more productive and healthier life, making the alerting effects of smoking and nicotine dispensable.

    For those whose sleep is poor and not satisfying enough, who want to fall asleep faster, or who just generally feel sleepy and tired throughout the day…take heed: if you smoke before bedtime, you will not only struggle to fall asleep because of the nicotine you’ve brought into your system, but your natural sleep-wake cycle will be disrupted, and you may even experience withdrawal symptoms before your morning alarm goes off, leaving you feeling even more restless and agitated when you wake up.

    What’s needed to help counter these effects is a better sleep evaluation and insights into how smoking is affecting sleep, and a customized plan to improve your rest and get the kind of sleep you need.

    About Sleeprate
    For smokers who feel like the only way to get to sleep is by having a quick smoke before bedtime, the reality is that once nicotine is out of your system, your sleep will improve dramatically and the restorative benefits of sleep will return.

    At Sleeprate, we can help you get there. Sleeprate’s mission is to help people around the world improve their lives through better sleep-life balance. We work tirelessly to improve the performance and availability of our world-class technologies and solutions, offering people all around the world the most effective, reliable and user-friendly sleep analysis, monitoring and assessment out there today – all in a single solution.

    Sleeprate’s core technology utilizes behavioral sleep medicine practices developed and implemented at Stanford University’s Behavioral Sleep Division. Sleeprate’s unique solution for better sleep-life balance was developed and customized as a step-by-step program to improve mental and physical performance, so that people can be more productive and effective throughout the day.

    To learn more about Sleeprate and how we’ve helped provide the most innovative and sophisticated sleep treatment solution in the market today, visit us at www.sleeprate.com.

    How to treat insomnia while quitting smoking

    If you’re considering quitting smoking, are currently giving up, or you’ve already quit, then well done!

    We all know of the harmful effects that cigarettes, tobacco and nicotine can have on our bodies1, so all three are excellent steps towards better overall health.

    Unfortunately, during the quitting process, you may find that you have trouble getting enough quality sleep. Smoking is chemically addictive, and this has been linked to sleep difficulties and insomnia, which may make it more of a challenge to quit.2

    No matter what stage you’re at, everyone needs sufficient sleep to awaken your best.

    Here is some more information to help you manage the symptoms of insomnia when quitting smoking, so you can say goodbye to the cigarettes and get enough quality sleep too.

    How is sleep affected by smoking?

    When you quit smoking, your body experiences nicotine withdrawal, which is known to cause disturbances in quality sleep.3

    Everyone is unique, so you may experience different symptoms. However the most common include:

    • a consistently poor quality sleep
    • waking up briefly, many times during the night
    • difficulty falling asleep
    • remaining awake for long periods
    • feeling tired and lethargic the following day

    When these are ongoing, it can fragment your sleep and cause insomnia.3

    If you find yourself suffering from insomnia while trying to quit smoking, give the following remedies a try to ease your discomfort and reclaim that precious slumber.

    Avoid napping

    While this may seem counterproductive, try not to nap during the day. Naps only last a short time here and there, and can throw your regular sleeping patterns out when you try to get a proper sleep at night.

    Allow yourself to unwind

    If you’re stressed, anxious or craving a cigarette, your mind is not relaxed enough to get in the right headspace for quality sleep.

    Try some simple deep breathing exercises before you go to bed to help ease your thoughts. Sit in your room in the dark, focus on your breath and breathe in for five seconds, hold for five seconds and then out for five seconds. Repeat this over and over again until you find your mind begins to settle.

    This may help you relax and settle in for a good night’s sleep ahead.

    Have a massage

    Another way to relax is by getting a massage before bed.

    If you have a willing partner, there is nothing quite like a massage to help work out the stress, feel more comfortable and drift off.

    Try some different foods and drink

    Have you heard that having a warm cup of milk before bed helps you sleep?

    Warm milk contains the amino acid L-tryptophan, a precursor to the sleep hormone melatonin, which helps your body produce melatonin that signals your body to wind down and sleep at night.5

    Other foods containing the amino acid L-tryptophan include chicken, turkey, fish, and shellfish, eggs, tofu and sunflower seeds – if you want to give any of those a try instead.

    Speak to your Doctor

    If some of the above tips aren’t helping you treat your insomnia as you quit smoking, it may be best to speak to your healthcare professional or GP. They may prescribe you medication or refer you to a psychologist for cognitive behaviour therapy (or CBT-i) which is an effective treatment practice for insomnia.

    Experiencing insomnia when quitting smoking

    Just remember that giving up cigarettes is a great decision for your health and well-being.

    Sleep disturbances and insomnia can be a challenge to deal with6 – but don’t give up! You’ve come so far and in the end, it will be worth it.

    In fact, the 14 day sleep challenge could be the perfect way to keep focused and on track during your journey.

    Take the 14 Day Sleep Challenge

    Do you want to wake up feeling more refreshed? Give our 14 Day Sleep Challenge a go.

    You can sign up for the 14 Day Sleep Challenge here, where you will receive regular emails with quick insights and information about how you can improve the quality of your sleep. You’ll be able to track your progress throughout the challenge and discover what you need to do to help get a better night’s sleep.

    All the best!

    Cigarette Smoking Causes Sleep Disturbances

    February 7, 2008 — Smoking cigarettes impairs sleep quality, possibly due to nicotine withdrawal, according to a study in the February issue of Chest, the journal of the American College of Chest Physicians.

    The study is among the first to isolate the effects of smoking on sleep. In previous research, it was unclear whether changes in sleep patterns were due to smoking itself or to the medical conditions underlying smoking such as heart disease or respiratory disease, said study author Naresh M. Punjabi, MD, PhD, associate professor of medicine and epidemiology, in the division of pulmonary and critical care medicine, at Johns Hopkins University, in Baltimore, Maryland.

    “Believe it or not, despite all the literature on smoking and medical conditions, not much has been done on smoking and EEG activity,” he told Medscape Neurology & Neurosurgery.

    Another Motivating Factor to Quit Smoking

    The results of this study could represent “yet another motivating factor” to convince smokers to quit the habit, said Dr. Punjabi. “From a preventive health perspective, I think it’s very important that we now add sleep disturbance to the armamentarium of issues related to smoking.”

    This current study was part of the larger Sleep Heart Health Study, a multicenter study on sleep-disordered breathing and cardiovascular disease. Among the more than 6400 subjects in that larger study, there were only 40 smokers who smoked at least 20 cigarettes a day, had no underlying medical conditions, and met the other criteria. For the study, these subjects were matched with 40 nonsmokers for age, sex, body-mass index, and race.

    To measure sleep architecture, the study included conventional visual classifications of EEG patterns as well as sophisticated spectral analysis of sleep EEG that uses mathematical analysis of brain-wave frequencies. The researchers studied the sleep pattern of the 40 matched pairs over 1 night at home.

    Smokers Spent More Time in Light Sleep

    There was no difference between smokers and nonsmokers in visual scoring, but the spectral analysis of brain-wave activity showed that compared with nonsmokers, smokers on average had a higher percentage of alpha power (15.6% vs 12.5%) and a lower percentage of delta power (59.7% vs 62.6%). This means that the smokers spent more time in light sleep and less time in deep sleep than their nonsmoking counterparts.

    The higher frequencies among smokers translate into faster brain activity, explained Dr. Punjabi. “Faster activity in EEG reflects activation, or not sleeping deeply, so we find the patterns more consistent with lighter sleep than deeper sleep.”

    As well, the discrepancies in the sleep EEG between smokers and nonsmokers appeared to be time dependent, with the biggest difference occurring in the early part of the sleep period. This makes sense, since nicotine stimulates the release of dopamine, norepinephrine, serotonin, and acetylcholine, all of which have been linked to wakefulness, and blood nicotine levels of smokers are highest at bedtime, authors note. Given that the half-life of nicotine is about 2 hours, minor withdrawal from nicotine throughout the night could have a further effect sleep architecture later in the sleep period.

    These results “provide a better understanding of the pathophysiologic effects of nicotine on sleep,” the authors write.

    Independent Effect On Sleep Architecture

    The researchers also asked the subjects how they had slept the day after their sleep was monitored. Lack of restful sleep was reported by 5.0% of the nonsmokers and 22.5% of the smokers. “On a ratio of roughly 4 to 1, smokers had more complaints of feeling unrested after the night of sleep than nonsmokers,” Dr. Punjabi told Medscape Neurology & Neurosurgery.

    Those subjects who had faster frequencies, or the lighter sleep, tended to be the ones who felt the least rested, he said. This, he added, did not come as a surprise, either. “We knew that smokers tend to have a lot of insomnia complaints; they have a hard time falling asleep and a hard time maintaining sleep.”

    Researchers asked the subjects about their caffeine and alcohol consumption and used various tools to measure their mental health. Self-reported alcohol consumption was similar in both groups, as were measures of mental health status. While a higher proportion of smokers reported daily caffeine consumption, this was not associated with the results of the EEG power spectral analysis.

    The study shows that cigarette smoking “can alter sleep architecture independent of factors such as age, gender, race, anthropometric measures, caffeine and alcohol consumption, medial comorbidity, and mental health status,” the authors conclude.

    Ramifications on Daily Basis

    The direct effects of smoking on sleep seen in this study should provide further ammunition for public health campaigns to reduce smoking. “The people who smoke are not getting a restful sleep, and that has ramifications for them on a daily basis; they’re tired, they’re going to be tired the next day, and most likely they will have diminished level of alertness,” said Dr. Punjabi. “Those are direct effects that poor sleep quality will have on their daily living.”

    The study might also spur development of sleep aids directed at smokers. “Perhaps if we understand this better we could tailor nicotine replacement in such a way to potentially avoid the withdrawal effects,” said Dr. Punjabi.

    The authors report no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

    Chest. 2008;133:427-432. Abstract

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