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Smoking leads to sleep disorders12 February, 2008 Recent research has added one more reason for sleep disturbance, one of the banes of the modern-day life. The study, published in the February 2008 issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians, shows that cigarette smokers are four times as likely as non-smokers to feel unrested after a night's sleep. It was also found that smokers spend less time in deep sleep and more time in light sleep than non-smokers – with the biggest differences in sleep patterns seen in the early stages of sleep. Researchers from the Johns Hopkins University School of Medicine, Baltimore, the United States, speculate that the stimulating effects of nicotine could cause smokers to experience nicotine withdrawal each night, leading to disturbances in sleep. Dr Naresh M Punjabi, of the Johns Hopkins University School of Medicine, wrote in the CHEST: “It is possible that smoking has time-dependent effects across the sleep period. 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.” In the study, Dr Punjabi and colleagues compared the sleep structure of 40 smokers with that of a matched group of 40 non-smokers, all of whom underwent home polysomnography. While previous studies comparing smokers and non-smokers have primarily used subjective measures of sleep, the study by the Johns Hopkins University School of Medicine included smoking as well as non-smoking subjects who were free of most medical co-morbidities and use of medication. Dr Punjabi continued: “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. In the absence of several medical conditions, sleep abnormalities in smokers could then be directly associated with cigarette use.” Besides, according to the authors, 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. Spectral analysis, they added, allowed them “to classify more objectively the sleep EEG signals and help detect subtle changes that may have been overlooked with visual scoring.” Visual scoring of sleep staging showed similar results between smokers and non-smokers. However, spectral analysis showed that subjects who smoked had a lower percentage of delta power (deep sleep) and a higher percentage of alpha power (light sleep).
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