TOBACCO WITHDRAWAL AND NICOTINE REPLACEMENT INFLUENCE OBJECTIVE MEASURES OF SLEEP

Research has not adequately characterized the impact of tobacco withdr awal on objectively assessed sleep parameters despite the recent inclu sion of insomnia as a nicotine withdrawal sign in the Diagnostic and S tatistical Manual of Mental Disorders (4th ed.; American Psychiatric A ssociation, 1994). Moreover, whether 24-hr nicotine replacement aids o r interferes with sleep during withdrawal is unknown. In a double-mask ed, randomized clinical trial, 34 cigarette smokers who were motivated to quit received either active nicotine patches or placebo patches wh ile quitting. Sleep was polysomnographically monitored for 2 precessat ion nights and 3 postcessation nights. The study demonstrates that amo ng dependent smokers (a) tobacco withdrawal increases objectively asse ssed sleep disturbance (sleep fragmentation) and (b) nicotine replacem ent results in postcessation improvements in important polysomnographi c measures of sleep quality (sleep fragmentation, Stage 3 and Stage 4 sleep).