Dual use of e-cigarettes, conventional cigarettes may worsen sleep quality

  • Boddu SA & al.
  • Am J Respir Crit Care Med
  • 17 Jul 2019

  • International Clinical Digest
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Takeaway

  • Dual use of e-cigarettes and conventional cigarettes, especially by women, is associated with poorer sleep quality in a cross-sectional cohort.

Why this matters

  • Dual use is the most common use pattern.
  • Link may be mediated by higher concentrations of nicotine and more frequent cough.

Study design

  • Cross-sectional cohort (n=274) responding to a nationwide online survey advertised by social media.
  • Pattern of use was assessed by the University of California San Diego inhalant use questionnaire.
  • Primary outcome was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI; range 0-21, with higher scores indicating worse sleep quality).
  • Cough was assessed by the Leicester Cough Questionnaire (LCQ, range 3-21, with higher scores denoting better QoL).
  • Funding: NIH; American Heart Association; others.

Key results

  • Dual users had highest scores on PSQI (8.77) vs e-cigarette users (6.87), conventional smokers (7.88), and nonsmokers (7.09; analysis of variance, P=.027).
    • Female dual users had higher PSQI scores compared with nonsmokers (mean difference, 3.43; P<.001 and increased sleep latency difference minutes p>
  • Dual users had the highest prevalence of chronic cough in past 30 days on LCQ (63.6%) vs all other groups; by logistic regression they had increased odds of coughing vs nonsmokers (aOR, 2.51; P=.013).

Limitations

  • Cross-sectional observational design.