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Medically Reviewed by Dr. Sahil Chopra
Each year, nearly 6 million people die worldwide from tobacco use and related diseases. Smoking has a long list of health risks, including cancer, depression, anxiety, heart disease, and much, much more.
But smoking also interferes with your sleep, which may come as a surprise to those who view it as a sleep aid. Many people “wind down” before bed with a cigarette, not realizing that as the nicotine rushes through their system, it disrupts their sleep architecture and leads to insomnia and can potentially worsen sleep-disordered breathing.
Fortunately, smoking is at an all-time low, thanks to growing awareness of the associated health risks and increasing availability of addiction treatment options. If you’re still on the fence about whether it’s time to quit, keep reading to learn how smoking wreaks havoc on your sleep and how you can sleep better during withdrawal.
Whether you’re smoking cigars or cigarettes, nicotine is no friend to your sleep. Smoking before bed is a terrible idea for several reasons.
Cigarettes contain nicotine, which is a stimulant. Even though people smoke in order to relax before bed, they’re actually telling their body to do just the opposite. Nicotine increases your heart rate and alertness, so you feel more awake when you’re trying to fall asleep.
Plus, nicotine is addictive and fast-acting. It enters your bloodstream and your brain within a few seconds. Unfortunately, within a matter of hours, it starts leaving the body. If you are addicted to nicotine, as most smokers are, you’re likely to experience withdrawal symptoms as you sleep – to the extent that your brain will wake you up to get more nicotine, and thus interrupt your slumber.
The less sleep you get, the more sleep deprived you become. So you can add the dangers of sleep deprivation to the long list of health risks you’ve accumulated from smoking. Sleep deprivation worsens your mood, ability to focus, and cognitive performance the following day. If your sleep deprivation becomes chronic, you can expect more serious long-term health risks like cancer and sleep disorders.
Regular smoking actually changes your sleep architecture. Sleep architecture refers to the cycle of sleep stages you experience during sleep – including light sleep, deep sleep, and REM sleep. Spending sufficient time in all of these is critical to having a restful night of good sleep.
Multiple studies have found smoking has negative effects on overall sleep time, as well as time spent within each sleep stage.
A 2013 study of mice showed that smoking tobacco can disrupt the circadian clock. The more the exposure to tobacco, the worse the disruption. In addition to poor sleep, the likelihood of depression, anxiety or another mood disorder also increased.
Some studies have shown that although sleep issues typically go away once someone quits smoking, they won’t ever sleep as well as their never-smoking peers.
Smoking is tied to two common sleep problems: insomnia and sleep-disordered breathing, such as snoring or sleep apnea.
Because nicotine is stimulating, it can wake your mind and body and cause sleep-onset insomnia, or difficulty falling asleep.
Depending on your level of addiction, awakening during the night due to withdrawal can lead to sleep-maintenance insomnia.
Sleep-disordered breathing is any kind of abnormal breathing during sleep. Snoring and sleep apnea are two types of sleep-disordered breathing
Snoring is noisy breathing during sleep that occurs when the sleeper’s upper airway is obstructed. Snoring is associated with increased risks of heart disease and diabetes, as well as the daytime fatigue associated with sleep deprivation.
Obstructive sleep apnea (OSA) develops due to blockage or obstruction of the tissues and nasal airways. A person with OSA will literally stop breathing momentarily during sleep, causing their brain to rouse them just enough to start breathing again. They may not consciously wake up, but their sleep cycle gets disrupted all the same – often resulting in insomnia and sleep deprivation.
Smoking is tied to OSA because some of the material in cigarettes cause the throat and nasal tissues to swell, resulting in the blockage that causes apneic episodes. In fact, people who smoke are 2.5 times more likely to have OSA.
If you share your bed with a child or partner, the irritants from your second-hand smoke can lead them to have OSA, too.
Yes. While you avoid some of the health risks of smoking by switching to e-cigarettes, vaping still delivers nicotine to your body and interferes with sleep.
As long as there is nicotine in your e-liquid, it will affect your sleep. You’re still exposing your body to nicotine.
Some people experience extreme fatigue once they quit smoking, especially if they go cold turkey.
Our brains rely on a neurotransmitter called acetylcholine to keep us awake and alert. When you smoke, nicotine mimics acetylcholine by binding to the same receptors in the brain. As a result, smokers feel awake and alert (the way they would with acetylcholine, but it’s actually due to the nicotine levels in their brain). If you stop smoking instantly, your brain suddenly has no acetylcholine or nicotine to rely on, and you feel extremely drowsy.
Fortunately, the brain will normalize your acetylcholine levels over time.
The best way to get better sleep is to quit smoking. It’s common for it to take multiple attempts before it finally sticks. 85% of smokers relapse within the first week. But if you keep at it and stick to your plan, you will be successful.
Talk to your doctor to find the best option for you, from going cold turkey to slowly transitioning using a combination of therapy, patches, gum, or something else.
Here’s the great news about quitting smoking: once you stop, your sleep problems go away, too. If you decide to stop smoking, accept and be aware that you’re going to experience some disturbed sleep in the initial month or so. It can take about 30 days for you to start sleeping normally again after quitting smoking. You’ll feel extremely exhausted at times, and unable to sleep at night even if you’re tired.
Follow these tips to make the transition a bit easier.
Avoid cigarettes and other stimulants 2 hours before bed. This includes caffeine, from coffee and soda as well as less obvious sources like chocolate. Everyone knows caffeine is a stimulant, but many don’t realize that smokers have a higher tolerance and metabolize it twice as fast. As a result, they often end up ingesting even more caffeine, mistakenly thinking it’s not affecting them when it is.
Also avoid heavy, extra sugary or fatty meals late at night. Try herbal teas that help induce sleep. These will keep you hydrated during this time and give your mouth something to do.
Exercise regularly, ideally in the morning and outside. Exercise in the morning in natural sunlight jolts your body awake, helping dispel any feelings of fatigue or drowsiness. It also helps reset your circadian clock so you’re naturally more tired by the time bedtime rolls around.
Exercise offers extra benefits unrelated to sleep. It provides a mental and emotional energy boost that will lift your mood and help you stay confident about quitting. Exercise also helps you keep your body weight stable despite the increased appetite that comes with laying off the nicotine.
Go to bed and wake up at the same time every day, even weekends. If you want to catch up on sleep, it’s best to go to bed as soon as you get sleepy while maintaining the same wake up time. Keep your bedroom cool and dark. Avoid stimulating electronics like computers, smartphones, and television in the hour before bed.
It’s probable you’ll feel exhausted during the day. Allow yourself a nap if necessary, but keep these to short power naps of 30 minutes or less. Any longer and you may fall into deep sleep, which upon waking will leave you drowsier than before.
Even though they’re uppers, many smokers relied on cigarettes for relaxation. Without cigarettes, you’ll have to find new ways to calm your mind and body. Good options include aromatherapy, deep breathing exercises, progressive muscle relaxation, meditation, yoga, warm baths, journaling, or reading.
Quitting is very hard. You’ll feel physically terrible, and the lack of dopamine in your brain will make you irritable and depressed. Talk to friends about how you’re feeling and ask them to help you stick to your quitting plan. Find local support groups.
Several organizations offer online resources to help you quit smoking for good.