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How to reduce the impact of nicotine on sleep

You can add ‘sleep better’ to the very long list of reasons to quit smoking. Similar to caffeine, nicotine is a stimulant, which people use because of its alerting properties. Studies have shown that nicotine acts as a stimulant by releasing molecules in the body that are associated with both arousal, and the inhibition of sleep. Vaping may not involve the inhalation of smoke but can deliver more powerful stimulant effects than smoked nicotine, disrupting sleep even further. 

 What is the impact of nicotine on sleep? 

Research has shown that compared to non-smokers, smokers have reduced deep sleep and therefore experience restless sleep (1).  Smoking, particularly when close to bedtime, also increases the amount of time it takes to fall asleep. In the morning hours when nicotine levels have dropped, withdrawal symptoms wake a smoker up to satisfy cravings before the morning alarm goes off. This leaves smokers feeling restless and agitated (2) 

The disruptive effects of nicotine on sleep may increase the likelihood of suffering from insomnia. Studies of adult men over a 10-year period (3), and of women over a 25-year period (4), have shown that those who smoked continuously were more likely to suffer from insomnia. Smoking increases the likelihood of breathing disorders that disrupt sleep, including asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnoea (OSA) (5). 

Quitting smoking and coping with withdrawal symptoms  

When quitting smoking many people experience withdrawal symptoms that can disrupt sleep and can last for up to 3 months (6). Evidence shows that sleep difficulties during withdrawal increase the risk of relapse or continuing consumption. Here are some tips to help you to limit sleep difficulties while you are quitting.  

  •  Make a plan to stop smoking. Advice on making a plan to change habits is found in the information sheet ‘How to change my sleep habits in order to get more sleep’ 
  •  Speak to your doctor about getting support from a local smoking cessation service. Evidence shows that we are more likely to quit smoking with expert help and advice.   
  •  Be aware that smoking cessation medications. e.g., bupropion, the nicotine patch, are known to increase sleep disturbance in the short-term11. 
  •  Be realistic and prepared for several change attempts. Relapse is common feature of behaviour change. To help you keep on track or get back on track: 
  • Share your plan to quit smoking with friends and family who can support and give encouragement. 
  • Make a list of reasons to quit and keep it visible. 
  • Smoking is often paired with other habits and situations, e.g. drinking wine or coffee, after a meal, at a bar or when we feel stressed. Reducing/avoiding these cues will help stay on track. 
  • Even better, create new non-smoking experiences: e.g. make new non-smoking friends etc. 
  • A brief bout of moderate exercise has been shown to reduce the desire to smoke and withdrawal discomfort.  

References 

  1. Zhang, L., Samet, J., Caffo, B., Bankman, I., & Punjabi, N. M. (2008). Power spectral analysis of EEG activity during sleep in cigarette smokers. Chest133(2), 427-432. 
  2. McNamara, J. P., Wang, J., Holiday, D. B., Warren, J. Y., Paradoa, M., Balkhi, A. M., … & McCrae, C. S. (2014). Sleep disturbances associated with cigarette smoking. Psychology, health & medicine19(4), 410-419. 
  3. Janson, C., Lindberg, E., Gislason, T., Elmasry, A., & Boman, G. (2001). Insomnia in men—a 10-year prospective population based study. Sleep24(4), 425-430. 
  4. Brook, D. W., Rubenstone, E., Zhang, C., & Brook, J. S. (2012). Trajectories of cigarette smoking in adulthood predict insomnia among women in late mid-life. Sleep medicine13(9), 1130-1137. 
  5. Htoo, A., Talwar, A., Feinsilver, S. H., & Greenberg, H. (2004). Smoking and sleep disorders. Medical Clinics88(6), 1575-1591. 
  6. Jaehne, A., Unbehaun, T., Feige, B., Cohrs, S., Rodenbeck, A., Schütz, A. L., & Riemann, D. (2015). Sleep changes in smokers before, during and 3 months after nicotine withdrawal. Addiction biology20(4), 747-755.