Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ; Department of Psychology, University of Nevada, Las Vegas, NV.
Department of Population Health and Disease Prevention, College of Health Sciences, University of California, Irvine, CA.
Sleep Health. 2021 Apr;7(2):177-182. doi: 10.1016/j.sleh.2020.10.006. Epub 2020 Nov 18.
Insomnia is a clinically verified nicotine withdrawal symptom. As nicotine is a stimulant, it is plausible that smoking at night could disturb sleep more than smoking at earlier times of the day, but this remains empirically unclear. This study examined smoking status and its associations with insomnia severity and sleep duration while considering the potential role of smoking time.
Data were derived from the Sleep and Healthy Activity Diet Environment and Socialization study, a community-based study of 1007 adults (n = 818; n = 189) aged 22-60 from the Philadelphia area. Smoking status and time of smoking were self-reported. Insomnia was assessed with the Insomnia Severity Index and categorized as none, mild, and moderate-to-severe. Sleep duration was assessed with one item from the National Health and Nutrition Examination Survey and categorized as very short, short, normal, and long. Ordinal and multinomial logistic regressions were used to determine the association of smoking status including smoking time with insomnia severity and sleep duration controlling for sociodemographic covariates.
Compared to nonsmoking, smoking was associated with experiencing increased insomnia (odds ratio = 2.5, 95% confidence interval [CI] 1.9, 3.4, P < .001) as well as very short (relative risk ratio = 1.9, 95% CI 1.1, 3.3) and short (relative risk ratio = 1.5, 95% CI 1.0, 2.3) sleep (vs normal sleep duration). Night-time smoking was significantly associated with greater insomnia and shorter sleep duration.
Findings provide evidence that smoking is associated with increased insomnia severity and shorter sleep duration, particularly nightly smoking. Sleep health should be considered in smoking cessation efforts.
失眠是一种经临床证实的尼古丁戒断症状。由于尼古丁是一种兴奋剂，因此晚上吸烟比一天中早些时候吸烟更有可能扰乱睡眠，但这在经验上仍不清楚。本研究检查了吸烟状况及其与失眠严重程度和睡眠时间的关系，同时考虑了吸烟时间的潜在作用。
数据来自睡眠与健康活动饮食环境和社交研究，这是一项基于社区的研究，涉及来自费城地区的 1007 名成年人（n=818；n=189），年龄在 22-60 岁之间。吸烟状况和吸烟时间由自我报告。使用失眠严重程度指数评估失眠，并分为无、轻度和中重度。使用国家健康和营养检查调查的一个项目评估睡眠时间，并分为非常短、短、正常和长。使用有序和多项逻辑回归来确定吸烟状况（包括吸烟时间）与失眠严重程度和睡眠时间的关联，同时控制社会人口统计学协变量。
与不吸烟相比，吸烟与失眠（优势比=2.5，95%置信区间[CI]1.9,3.4，P<0.001）以及非常短（相对风险比=1.9，95%CI1.1,3.3）和短（相对风险比=1.5，95%CI1.0,2.3）睡眠时间（与正常睡眠时间相比）相关。夜间吸烟与失眠加重和睡眠时间缩短显著相关。
研究结果提供了证据表明吸烟与失眠严重程度增加和睡眠时间缩短有关，尤其是夜间吸烟。在戒烟努力中应考虑睡眠健康。
