Smoking, stopping smoking, and sleep

Blog Post created by NDC.Treatment.Team on Nov 20, 2019

Sleep can be incredibly important for health. Good sleep improves concentration, productivity, mood, and weight metabolism.  Poor sleep is a factor in heart disease, stroke, systemic inflammation, and mental health.  However, developing good sleep patterns can be a challenge, and good sleep is complicated by smoking.


Sleep quality is measured in a couple of ways. ‘Sleep continuity’ is basically the amount of time a person spends in bed, as a ratio of time sleeping; for example, factors measured to assess sleep continuity include sleep latency or time getting to sleep, total sleep time, and frequency of waking at night.  Sleep architecture is another measure of sleep quality.  Sleep architecture is usually evaluated with overnight sleep studies.  Good sleepers spend more time in deeper sleep, both dreaming (REM or rapid eye movement) and  in non-REM sleep. 


Most studies find that non-smokers have better sleep continuity and sleep architecture than non-smokers.  Smokers on average sleep less, take longer to get to sleep, and wake more often than non-smokers.  Waking more often at night is directly correlated with the higher addiction.   Smokers also spend less time in deep sleep states, both REM and Non-REM.  People who smoke also subjectively report poorer sleep, and are in general more drowsy and sleepy during the day.


Unfortunately this seems to worsen in the short term when people are stopping smoking.  During the first few weeks of smoking cessation, people who stopped smoking had worse sleep continuity, more waking at night and poorer self-reported sleep compared with those who did not stop.  Those who measured more addicted to tobacco did worse than those measuring less addicted.  This makes sense, because poor sleep and insomnia are withdrawal symptoms; however use of nicotine patch, or varenicline did not reduce sleep disturbance and tended to increase them. 


Sleep disturbances do get better over time when people stop smoking. Studies have found that post cessation sleep disturbances peak during the first week stopping.   Four to twelve weeks after stopping, sleep quality returns to at least pre-cessation baseline, and for many sleep is better than before they stopped.


The bottom line is that it may be important to take steps to improve your sleep as you stop smoking.  Good habits do work to improve sleep.  Check out our six tips to improve sleep which we hope you find helpful. 


Kathy Zarling, MS, APRN