Introduction: Sleep disturbances may make smoking cessation more difficult and relapses more frequent.
State of the art: Nicotine increases vigilance and decreases sleeping time. Cigarette smoking is associated both with difficulty initiating and maintaining sleep. The disruption is associated with arousals on EEG recordings. Smoking promotes snoring and obstructive sleep apnoea. Insomnia is recognised as one of the criteria for nicotine withdrawal syndrome. Awakening from sleep and daytime sleepiness can occur frequently in this situation and are predictive factors for relapse. Nicotine replacement therapy itself induces frequent awakenings, a decrease in total sleep duration, early morning waking, dreams and sometimes nightmares with associated arousals on EEG. Sleep disruption is the most common side effect observed with bupropion when used as an aid in smoking cessation.
Perspectives: Sleep disturbance must be taken into account in smoking cessation programs. More detailed investigations are needed, both clinical studies looking at measures of the main sleep parameters using sleep diaries and more detailed studies using polysomnography.
Conclusion: In smokers, sleep disturbances must be taken into account, because they increase cardio-vascular and cerebro-vascular morbidity. During smoking cessation, relieving these disturbances should make quitting easier and prevent relapses.