Nicotine: how does it affect your sleep?

Once upon a time, smoking tobacco was widely promoted as good for both health and relaxation. It’s surprising how times change!

These days, it’s well established that smoking tobacco isn’t the healthiest choice you can make. For instance, if you smoke, you have an increased risk of:

• developing a variety of cancers
• suffering a heart attack or stroke
• worsened symptoms from respiratory infections (e.g. common cold, flu, COVID-19)¹.

It’s not just the smoker’s health that’s affected. People exposed to second-hand smoke are at increased risk of lung cancer and children exposed to second-hand smoke are at increased risk of developing meningitis and suffering from cot death.

Clearly, these health implications are not to be taken lightly.

There is another, less widely known, effect of smoking on health too – the effect of smoking on sleep.

We’ve covered the importance of sleep in numerous articles and focused on why getting a good night’s sleep is key to (but not limited to):

• weight control
• mood improvement
• physical strength
• mental performance

Over time, a lack of sleep will harm your quality of life.

In this article, we look more closely at the effect of smoking tobacco and its psychoactive component — nicotine — on sleep.

We’ll also take a quick look at what to expect when quitting smoking and cutting out nicotine altogether.

Why does smoking impact our sleep?

Smoking tobacco is incredibly addictive. This is mostly due to the presence of nicotine (a stimulant) in tobacco products. Once in the body, nicotine stimulates the release of several neurotransmitters or chemical messengers².

Release of these neurotransmitters (e.g. serotonin, dopamine and gamma-aminobutryic acid) can be associated with pleasurable feelings and a sense of wellbeing. However, fluctuations in these neurotransmitter levels can also affect a person’s sleep-wake cycle.

So we know that smoking is associated with nicotine and that nicotine affects sleep. Let’s find out how.

Smoking and sleep disturbance: the good and the bad

If you’re a regular smoker, you’re more likely to:

• take longer to fall asleep once in bed ²
• spend a greater amount of time in bed awake, rather than asleep
• sleep for less time overall
• spend less time in deep, restorative sleep³.

These effects aren’t universal and, in fact, some people (e.g. those living with depression) will experience sleep improvement following nicotine consumption⁴.

But a number of respiratory problems that affect sleep, like asthma and sleep apnoea, are exacerbated by smoking.

Consequently, smokers and other nicotine users often report difficulty getting up in the morning and experience increased daytime sleepiness^2 5. But it gets worse! Smoking is well known for causing lung cancer but another risk factor is reduced sleep⁶.

It’s also been suggested that, because of the timing of people’s nicotine intake compared to other stimulants, the impact of nicotine on sleep may be more marked than in a number of other stimulants – including cocaine⁷.

And that’s not all! The longer you’ve been smoking for, the more likely you are to develop insomnia or insomnia-like symptoms. Habitual smokers who started smoking in adolescence appear to be more at risk of developing insomnia than those who started later in life⁸ or those who smoke infrequently.

Surprisingly, second-hand smoke also affects sleep. Passive smokers are more likely to report poor sleep than those not exposed to any form of tobacco smoke^9 10.

How can nicotine replacement therapy affect sleep?

Although not as damaging to your health as smoking tobacco, nicotine in any form can disrupt your sleep. E-cigarettes (vapes), patches and nicotine gum are a safer alternative to cigarettes but they’re still likely to spoil your sleep. Nicotine is a nightmare when it comes to restful nights.

E-cigarette users often complain of the same sleep issues affecting conventional cigarette smokers. They also report night-time breathing issues, both of these being observed in daily and non-daily users of e-cigarettes¹¹. Sleep disturbances are also reported by users of patches and gum ⁴.

So, if smoking and more general nicotine consumption are bad for sleep, it’s perfectly natural to ask: Just what does someone who’s trying to quit smoking do?

Managing nicotine withdrawal: quitting smoking without going cold turkey on sleep

Let’s be frank. If nicotine consumption is bad for sleep and smoking is harmful to health in general, it’s a good idea to quit both. But they’re also remarkably addictive and come with some very unpleasant withdrawal symptoms. These include¹²:

• Poor mood
• Fear
• Irritability
• Restlessness

There’s also another one: Sleep disturbance (this can include sleeping too much as well as too little).

At this point, if you’re trying to quit, it sounds like you’d be in for a hard time with sleep and maybe that cutting down your nicotine consumption simply isn’t worth the trouble. This is not the case, but it is a good idea to know what’s likely to happen if you’re trying to quit, and to plan accordingly.

First things first. If you’ve been smoking for a long time then you’re likely to suffer worse withdrawal symptoms. You might find that you’re more sleepy than usual when trying to quit⁴ but this should subside after a few weeks. You may also find that you’re able to fall asleep more easily, and sleep for longer once in bed.

Nicotine replacement therapy can help regulate some of the changes you’ll experience but the literature suggests that how you use it dictates what impact it’ll have on your sleep. For example, if you’re a heavy smoker using a 16-hour patch, you may experience nicotine withdrawal during the night, leading to undesired waking. This may be helped by using a 24-hour patch⁴ or by changing the time you put the patch on.

Patches may also increase the amount of restorative sleep you get per night as your body withdraws from nicotine¹².

Exercise has also been shown to improve sleep during nicotine withdrawal. It doesn’t need to be anything too strenuous. Simply walking on a treadmill or using an exercise bike is a good start ¹³.

Finally, some work has shown that CBTi delivered by trained staff, from a reputable service such as Sleepstation, may help improve your sleep when trying to quit smoking. Quitting smoking and cutting out nicotine is never easy ¹⁴. It can be pretty daunting when you’re trying to do both. But using established approaches such as sleep restriction, sleep hygiene, thought blocking and relaxation can help.

In summary

• All forms of nicotine consumption are bad for sleep
• Smoking can make respiratory issues that affect sleep worse
• The best thing to do is stop using any form of nicotine, but this can be hard
• Exercise, nicotine patches and CBTi may be able to help if you’re keen to quit smoking and cut out nicotine

If you’re having a hard time quitting smoking, and are finding that you’re losing sleep over it, the Sleepstation team may be able to help. We’ve helped many thousands of people from all walks of life realise their dream of better sleep.