Smokers Get Less Restorative Sleep
> 2/5/2008 3:11:16 PM

Many smokers feel that cigarettes relax them, but the nicotine that they inhale is a powerful stimulant that more often agitates the nervous system. A study in the journal Chest, led by Dr. Naresh Punjabi, uses both subjective and objective measurement to demonstrate that smokers get less restorative sleep. Sleep-deprivation can now be added to the long list of cigarette damages, and it can easily amplify the danger from well-established cardiovascular threats already exacerbated by smoking.

The many dangers of smoking are what made this study so complex. Dr. Punjabi had to correct for all of the negative health consequences of smoking that can interrupt sleep on their own. For example, general lung damage could keep a smoker up all night coughing. Even after painstakingly controlling for all noticeable health problems, there was a significant difference between the quality of smoker sleep and non-smoker sleep.

Many of the smokers were not aware that their sleep was substandard, but on average they were four times more likely to report non-restful sleep; 22.5% of smokers reported waking without adequate feelings of restfulness, as opposed to only 5% of non-smokers. This was not due to the length of sleep, but rather to variability in its restorative quality. That means that even if the average smoker finds time for eight hours in bed every night (a generously optimistic scenario), they will feel worn-out on more than one day a week.

While the subjective impression of sleep quality is important, this study went even further monitoring each subject during sleep with an electroencephalogram (EEG). The EEG scanned four frequencies at 30-second intervals, and it found significantly different frequency proportions for the two groups. The smoking group showed 15.1% lower delta-wave bandwidth and 58.3% higher alpha-wave bandwidth. As delta waves form the deepest states of sleep, lower levels can reasonably be linked directly to unsatisfactory restoration.

The knowledge that smoking disrupts sleep is valuable both as another warning and as a guideline for cessation attempts. Smokers who think that their daily fix keeps them more alert may have second thoughts about lighting up if told that their grogginess is actually caused by nicotine, which can only temporarily dispel it. Cessation aids may have to take into account the possibility that nicotine withdrawal during sleep is a major reason why quitting is so difficult, a concept that we discussed previously in reference to alcohol. Perhaps fine-tuned nicotine patches at night can lead to better rest and less of a need to smoke to get going in the morning.

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