Objectives

Smoking is associated with sleep disturbances. The aim of this study was to analyze whether sleep disturbances are predictors of smoking cessation and whether continued smoking is associated with the development of sleep disturbances.

Methods

A questionnaire was sent to randomly selected men and women in Northern Europe in 1999–2001 (RHINE II) and was followed up by a questionnaire in 2010–2012 (RHINE III). The study population consisted of 2568 participants who were smokers at baseline and provided data on smoking at follow-up. Insomnia symptoms were defined as having difficulty initiating and/or maintaining sleep and/or early morning awakening ≥3 nights/week. Multiple logistic regression analyses were performed to calculate odds ratios (OR).

Results

Subjects with difficulty initiating sleep (adjusted odds ratio; 95% confidence interval: 0.6; 0.4–0.8), difficulty maintaining sleep (0.7; 0.5–0.9), early morning awakening (0.6; 0.4–0.8), any insomnia symptom (0.6; 0.5–0.8) or excessive daytime sleepiness (0.7; 0.5–0.8) were less likely to achieve long-term smoking cessation after adjustment for age, BMI, pack-years, hypertension, diabetes, chronic bronchitis, rhinitis, asthma, gender and BMI difference. There was no significant association between snoring and smoking cessation. In subjects without sleep disturbance at baseline, continued smoking increased the risk of developing difficulty initiating sleep during the follow-up period compared with those that had quit smoking (adj. OR 1.7, 95% CI 1.2–2.3).

Conclusions

Insomnia symptoms and excessive daytime sleepiness negatively predict smoking cessation. Smoking is a risk factor for the development of difficulty initiating sleep. Treatment for sleep disturbances should be included in smoking-cessation programs.

中文翻译：

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有失眠症状的吸烟者戒烟的可能性较小。

目标

吸烟与睡眠障碍有关。这项研究的目的是分析睡眠障碍是否是戒烟的预兆，以及继续吸烟是否与睡眠障碍的发展有关。

方法

在1999–2001年向北欧随机选择的男性和女性发送了问卷（RHINE II），随后在2010–2012年又进行了问卷调查（RHINE III）。研究人群包括2568名基线吸烟者，并在随访时提供了吸烟数据。失眠症状定义为难以启动和/或维持睡眠和/或清晨醒来≥每周3晚。进行了多个逻辑回归分析以计算比值比（OR）。

结果

难以入睡的受试者（调整比值比； 95％置信区间：0.6; 0.4-0.8），难以维持睡眠（0.7; 0.5-0.9），清晨醒来（0.6; 0.4-0.8），任何失眠症状（0.6;调整年龄，BMI，包年，高血压，糖尿病，慢性支气管炎，鼻炎，哮喘，性别和BMI后，长期戒烟的可能性较小（0.5-0.8）或白天过度嗜睡（0.7; 0.5-0.8）区别。打ing与戒烟之间没有显着关联。在基线时无睡眠障碍的受试者中，与那些戒烟的受试者相比，在随访期间继续吸烟增加了难以入睡的风险（调整为1.7，95％CI为1.2-2.3）。

结论

失眠症状和白天过多的嗜睡预示着戒烟。吸烟是引发入睡困难的危险因素。戒烟计划应包括对睡眠障碍的治疗。