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How smoking affects your sleep
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How smoking affects your sleep

You may be aware of the many health risks of smoking, but did you know it can also impact your sleep?

Smoking's nighttime effects

Smokers can have problems falling and staying asleep and are more likely to develop breathing issues and restless legs. Smoking disturbs your sleep cycles, leading to poorer sleep quality, struggles to get up in the morning and decreased alertness. One study found that 20% of cigarette smokers awoke during the night with a nicotine craving1. When you’re a smoker, you may find yourself in a never-ending cycle. Sleep deprivation can lead to an increase in the number of cigarettes you smoke, and the more you smoke, the harder it can be to fall or stay asleep. And if you’re trying to quit, any lack of sleep can make you more likely to relapse.

Health risks of smoking

More than 16 million Americans are living with a disease caused by smoking, from cancer, heart disease, and stroke to lung disease, diabetes, and chronic obstructive pulmonary disease (COPD). Add another life-threatening risk factor to this list: obstructive sleep apnea (OSA).

By impacting your breathing, chronic smoking makes you susceptible to OSA, which is a partial or complete collapse of the upper airway that causes you to stop breathing as you sleep. Because your brain spends the night fighting for oxygen, your sleep cycles are disrupted, and you wake up feeling drained, exhausted, or sore. OSA is a serious condition that, if left untreated, can be deadly. The good news is that former smokers benefit from a decreased risk of developing OSA.

Nicotine and Restless Legs Syndrome

A common sleep problem, Restless Legs Syndrome (RLS) can be affected by the nicotine you’re taking in from smoking. Studies have shown that RLS patients have higher levels of nighttime cigarette smoking, likely because nicotine may help alleviate some RLS symptoms2. But there can be a high price to pay for easing symptoms by smoking. If you’re on medication for RLS, smoking can actually reduce the effect of the medication, in turn requiring a higher dose, which can then increase your medication’s side3.

Smoking cessation effects

Sleep issues are also a factor when undertaking the good work of trying to quit smoking. While experiencing nicotine withdrawal, you may find that you wake up more frequently, your sleep quality declines, you’re tired during the day, and you even have symptoms of depression1. If you’re in a smoking cessation program, you may be interested to learn the treatments affect your sleep differently. Those who use a low-dose, long-acting nicotine patch tend to show significant improvement in the sleep issues associated with withdrawal, while those on nicotine gum replacement therapy do not1.

Tips to help you sleep while you’re quitting

Consider these suggestions that will not only help your sleep but also boost your smoking cessation efforts:
  • Cut back on caffeine. You metabolize caffeine faster than a non-smoker, making you jittery and irritable (which you may already be experiencing from trying to stay off nicotine).
  • De-stress with a warm bath, light stretching or some other form of relaxation that distracts you from smoking.
  • Explore new techniques to calm your mind such as meditation, yoga, and breathing exercises.
  • Get some exercise—brisk walks are great for physical health and can help you fight those nicotine cravings.
  • Reward yourself with enjoyable activities like watching a movie or reading a book.
  • Spend time with supportive people (hopefully nonsmokers) you can confide in about trying to quit smoking.
  • Don’t be discouraged if you’ve tried to quit and failed. It can take a few attempts, so stay positive and keep trying!
  • (1) Jaehne A, Loessl B, Barkai Z, et al., Effects of nicotine on sleep during consumption, withdrawal and replacement therapy. Sleep Med Rev 2009;13:363-77
  • (2)Oksenberg A. Alleviation of severe RLS symptoms by cigarette smoking. J Clin Sleep Med 2010;6(5):489-90
  • (3) Juergens TM. Adverse effects of ropinirole-treated RLS during smoking cessation. J Clin Sleep Med 2008;4(4):371-2

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