Sleep disturbance and daytime sleepiness in cigarette smokers attempting to quit without treatment

Relapse rates are high in cigarette smokers attempting to quit. Research suggests disturbed sleep may be associated with smoking resumption. We investigated nighttime sleep and daytime sleepiness in smokers, before and during a quit attempt without treatment. Fourteen smokers (16.2 +/- 6.2 cigarettes per day; ages 27.6 +/- 5.6 years) spent three consecutive nights in a sleep laboratory including polysomnographic recording. Smokers initiated a quit attempt after smoking one last cigarette immediately following the first night. Changes from smoking to abstinence in sleep variables and self-reported sleepiness were investigated. Results were compared to an age- and sex-matched group of non-smokers from a different study. Compared to after smoking, sleep latency dropped by 17 +/- 7 min (mean +/- SEM) during abstinence. When compared to controls, smokers had more disturbed sleep both before and during the quit attempt, with more stage N1 sleep, less stage N3 (i.e., slow wave) sleep, longer latency to stage N3, and more arousals, despite similar total sleep time. Daytime sleepiness was higher in the smokers compared to controls both before and during the quit attempt. All smokers in this study relapsed within 2 weeks. Smokers who had more stage N3 sleep before the quit attempt took longer to relapse. Although sleep latency was reduced after quitting, sleep disturbance persisted during the quit attempt, and daytime sleepiness remained. Our findings suggest that interventions increasing stage N3 sleep (e.g., through physical exercise or acoustic stimulation) may help to improve smoking cessation rates.