EFFECTS OF 24-HR NICOTINE REPLACEMENT ON SLEEP AND DAYTIME ACTIVITY DURING SMOKING CESSATION

Background. This study uses wrist actigraphy to assess the effects of 24-hr transdermal nicotine replacement on the sleep and daytime activi ty of smokers during smoking cessation. Methods. Seventy-one subjects grouped as light (n = 23), moderate (n = 24), or heavy (n = 24) smoker s were randomly assigned to placebo or 11, 22, or 44 mg/day doses of t ransdermal nicotine for 1 week of intensive inpatient treatment of nic otine dependence, Outpatient patch therapy continued for 7 weeks follo wing the inpatient stay. Those initially on placebo were randomly assi gned to 11 or 22 mg/day, and those initially on 44 mg/day were reduced to 22 mg/day at Week 4. Results. There was a significant decrease in daytime wrist activity during patch therapy and the 1st week off patch therapy. These changes in daytime wrist activity were positively corr elated with percentage of nicotine and cotinine replacement. No change s from baseline in sleep (sleep efficiency or wrist activity) were det ected, nor were there differences in sleep among the four patch doses. Conclusions. Using wrist actigraphy, this study failed to show any di sturbing effects of 24-hr high-dose nicotine replacement on sleep. Low er levels of nicotine replacement were associated with a decrease from baseline in daytime wrist activity. (C) 1996 Academic Press, Inc.