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Health behaviour

Do cigarette smokers sleep worse than nonsmokers in central China?

Liao Y, Xie L, Chen X, et al. · BMC public health · 2019

Open access · cc by · source: Europe PMC

Among 26,282 Hunan residents, smokers (25.3%) scored worse on almost every PSQI domain and more often had sleep disturbance (32.7% vs 24.5%).

Study at a glance

Design
Cross-sectional — Population-based multi-stage sample of rural and urban Hunan, China (Sep–Oct 2012); PSQI among smokers vs nonsmokers.
N
N=26282 · 27,300 sampled; 26,282 (97.3%) completed smoking self-report (6,650 smokers; 19,632 nonsmokers); PSQI n=26,035.
Population
General-population residents of Hunan province, China, ages 12–99.
Outcome
PSQI global score and sleep disturbance (PSQI >5), plus smoking-characteristic correlates among smokers.

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Key findings

Smoking prevalence was 25.3% (45% of men, 3% of women). Smokers had worse subjective sleep quality, latency, duration, efficiency, and disturbances, and more daytime dysfunction. Among smokers, poor sleep tracked more years smoked, quit attempts, and craving, but fewer cigarettes per day.

Methodology

Used multi-stage sampling in rural and urban Hunan (Sep–Oct 2012), defined current smokers as ≥100 lifetime cigarettes and smoking in the last 28 days, and compared Pittsburgh Sleep Quality Index scores, with regressions among smokers for cigarettes/day, years smoked, quit attempts, and craving.

Limitations

A cross-section cannot prove smoking caused insomnia; reverse causation (poor sleep prompting smoking) and residual confounding (alcohol was much more common in smokers) remain possible.

How this study connects

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