Impact of smoking on sleep macro- and microstructure

Minh Khoa Truong; Mathieu Berger; José Haba-Rubio; Francesca Siclari; Pedro Marques-Vidal; Raphaël Heinzer

doi:10.1016/j.sleep.2021.05.024

Impact of smoking on sleep macro- and microstructure

Sleep Med. 2021 Aug:84:86-92. doi: 10.1016/j.sleep.2021.05.024. Epub 2021 May 28.

Authors

Minh Khoa Truong¹, Mathieu Berger², José Haba-Rubio², Francesca Siclari³, Pedro Marques-Vidal⁴, Raphaël Heinzer⁵

Affiliations

¹ Department of Medicine, Service of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland. Electronic address: Minh-Khoa.Truong@chuv.ch.
² Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
³ Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland; Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
⁴ Department of Medicine, Service of Internal Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
⁵ Department of Medicine, Service of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland; Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.

PMID: 34126401
DOI: 10.1016/j.sleep.2021.05.024

Abstract

Objectives: Existing data suggest that smoking may be associated with sleep disturbances. This study aimed to determine the association between smoking and both subjective and objective sleep quality.

Methods: Cross-sectional analysis of sleep characteristics in 3233 participants from the population-based CoLaus-HypnoLaus cohort (52.2% women, mean age 56.6 ± 10.2 years) who completed questionnaires on sleep quality, of whom 1489 (46%) had a full polysomnography. Smoking data were self-reported; participants were classified by smoking status as current, former or never smokers. Primary outcomes were subjective sleep quality assessed by sleep questionnaires, and objective sleep quality based on polysomnography (sleep macrostructure), including power spectral analysis of the electroencephalogram on C4 electrode (sleep microstructure), quantifying the relative amount of delta power (1-4 Hz), a marker of sleep depth, and arousal-associated alpha power (8-12 Hz).

Results: Current smokers had a shift toward faster sleep electroencephalogram activity with lower delta power in non-REM sleep compared with former and never smokers (-2.8 ± 0.4% and -2.4 ± 0.4%, respectively; both p < 0.001) and higher alpha power (+0.8 ± 0.2%; p < 0.001) compared with never smokers. There was a dose-dependent negative association between electroencephalogram delta power and smoking intensity (r² = -1.2 [-1.9, -0.5]; p = 0.001). Additionally, mean nocturnal oxygen saturation was lower in current smokers.

Conclusions: Current smokers had decreased objective sleep quality, with a dose-dependent association between smoking intensity and decrease in electroencephalogram delta power during non-REM sleep, in addition to an increase in alpha power. Considering the importance of sleep quality for wellbeing and health, these results provide further data to support smoking cessation.

Keywords: Delta power; Polysomnography; Power spectral analysis; Sleep quality; Sleep structure; Smoking.

MeSH terms

Aged
Cross-Sectional Studies
Electroencephalography*
Female
Humans
Male
Middle Aged
Polysomnography
Sleep*
Smoking