Smoking and its Impact on Sleep Apnoea

Last updated on February 20th, 2024 at 09:54 am

How does smoking affect sleep?

Nicotine is known to keep the body stimulated, making it difficult and uncomfortable to get to sleep. It is an irritant which swells the nose and throat, restricting space for easy airflow. This makes breathing harder as the throat tissue becomes irritated and swollen.

The immediate effects can be daytime fatigue, concentration problems, increased irritability and suffering from a dry or sore throat in the morning.

Quitting smoking can reduce the severity of the sleep condition and help reduce symptoms.

Can smoking cause snoring?

The connection between smoking and snoring comes from nicotine, which is an irritant that produces inflammation and swelling of the airways. It can worsen the symptoms of sleep disorders like Obstructive Sleep Apnoea (OSA) and insomnia. The nicotine can also cause the muscles of the airways to relax as you sleep, further restricting breathing and increasing the chances of interruptions to sleep. Those who smoke commonly have increased snoring as a result of airway obstructions. Studies show that the risk of snoring is over twice as likely in smokers than in non-smokers (1).

Can smoking cause Sleep Apnoea?

The simple answer is yes; smoking can cause Sleep Apnoea. One of the main symptoms of OSA is loud snoring due to collapsing of the airways during sleep, resulting in breathing obstructions and choking during the night.

Tobacco is very addictive due to nicotine. Nicotine releases neurotransmitters; examples of these include serotonin and dopamine. Neurotransmitters can be linked with feelings of enjoyment. However, fluctuations with these neurotransmitter levels also have an impact on your sleep-wake cycle.

Smokers tend to take longer to fall asleep, sleep for less time overall, spend less time in restorative or deep sleep and are usually awake more than they are asleep. Respiratory problems which affect sleep, such as Asthma and Sleep Apnoea, are made worse by smoking, as well as conditions such as Insomnia. Secondhand smoke also affects sleep, so not only would your own health be impacted, but those around you are also likely to struggle with getting to sleep.

By quitting smoking, you can prevent adding to conditions contributing to Obstructive Sleep Apnoea and the numerous diseases linked to smoking.

Nicotine and Sleep Apnoea

Nicotine is a stimulant, and smoking can conceal feelings of tiredness, making it difficult to recognise symptoms associated with Obstructive Sleep Apnoea. When quitting smoking, the withdrawal symptoms are difficult to manage. At night you may struggle initially to settle to sleep as a result. Nicotine will keep you feeling awake and alert, which can lead to a poor night’s sleep, leaving you not only feeling tired but also putting you at risk of developing other health conditions. These can include but are not exclusive to:

• Mood Swings
• Changes in weight
• Impact on mental performance

How do I know smoking is affecting my sleep?

Smoking and Sleep Apnoea can impact your airways. By not adhering to OSA treatment, such as CPAP therapy, and continuing to smoke, the risk of serious health conditions increases significantly. Here are some common physical and emotional symptoms of how smoking affects your sleep:

Physical symptoms

• Frequent awakenings during the night
• Snoring
• Swelling of throat and nose
• Difficulty breathing
• Damage to upper airway muscles
• High blood pressure
• Breathing is worse after quitting smoking temporarily

Emotional symptoms

• Irritability
• Daytime fatigue
• Depression
• Difficulty concentrating

Why is my breathing worse after quitting smoking?

Some people have found that after quitting smoking, their breathing has become more difficult. This is because tobacco smoke paralyzes and destroys the tiny hair-like structures in the airways called cilia. The cilia that remain have trouble sweeping mucus out of the lungs. When you stop smoking, the cilia regrow and become active again. Your body needs time to adjust and detoxify from the smoke and nicotine, so it is common for people to experience difficulty breathing for the first couple of months.

Once you quit smoking, you may find it can take up to one month for your lung function to improve. This will also increase circulation, too. In around nine months, the cilia begin to function normally, and symptoms like coughing and shortness of breath become less frequent.

Long term effects of smoking

By continuing to smoke and leaving Sleep Apnoea untreated, you pose the risk of long-term health implications on your body. Here are some of the potential long-term effects of untreated Sleep Apnoea and smoking:

Stroke: Sleep Apnoea is a risk factor for a stroke. When left untreated, Sleep Apnoea is linked with poor outcomes after stroke. Stroke is the second-leading cause of death worldwide.

Heart disease: Conditions like heart disease put you at a higher risk of developing Obstructive Sleep Apnoea. Smoking can increase your chances of becoming affected.

Cancer: It is widely known that smoking causes Cancer, Sleep Apnoea is more common among cancer patients, with almost 30 per cent reporting daytime fatigue(2).

Metabolic syndrome: The metabolic syndrome is an increased risk for developing cardiovascular disease and type 2 diabetes mellitus. Studies indicate that Sleep Apnoea may be a manifestation of the metabolic syndrome.

Decreased mental abilities: Sleep Apnoea has been widely known to impact people’s memory and day-to-day cognitive functioning.

Oxidative stress: This is when there are too many unstable molecules called free radicals in the body and not enough antioxidants to get rid of them. This can lead to cell and tissue damage. This damage can also result in inflammation. These factors can lead to lifelong diseases such as diabetes or cancer.

Inflammation: Obstructive Sleep Apnoea promotes a persistent low-intensity inflammatory state. Inflammation is associated with changes in mood, behaviour, cardiovascular function and metabolism.

Solutions

We can offer support services for those who suspect they may have Sleep Apnoea and provide equipment for people already living with the condition.

Those who are confirmed to show the presence of Sleep Apnoea will be advised of the appropriate treatment depending on the severity of their disorder (positional, mild, moderate, or severe). The severity of OSA depends on your Apnoea Hypopnoea Index. These treatments can help provide significantly better sleep quality.

• Healthy changes to your lifestyle improve how you feel and your mood.
• Quitting smoking will help long-term to improve your breathing as well as overall physical health.
• Exercising regularly and losing weight can improve your physical and mental health as well as reduce the chance of having Obstructive Sleep Apnoea.
• Save money and invest it into your health with the money you would spend on nicotine products.
• Ensure you are well rested; sleep can do wonders for your body.

Nicotine is a highly addictive substance, and careful planning and plenty of support and encouragement will help you when deciding to quit.

You can also consider joining a support group or taking advice and getting support from a friend or family member who has previously quit smoking. Another option to consider when quitting smoking is nicotine replacement therapy (NRT) to help quit smoking. Products include nicotine patches and gum, which help reduce cravings and ease withdrawal symptoms. 

Non-nicotine medications are also available, but similar to NRT, it is best to speak to your doctor about what is best for you. Alternative methods, such as acupuncture, yoga and hypnosis, may also help you on your way to becoming smoke-free.

For free help quitting smoking, visit – NHS quit smoking support

Summary

If Sleep Apnoea is left untreated, it can increase your blood pressure, put you at further risk of heart disease and make your breathing more difficult. Smoking will only aid this and apply further pressure on your health.

These are just a few reasons why getting treatment is essential to your health and should be considered to improve your cardiovascular health and overall well-being.

If you believe you could be suffering from a sleep disorder, contact us today for advice and support.

References

1. Krishnan V, Dixon-Williams S, Thornton JD. (2014) Where there is smoke…there is sleep apnea: exploring the relationship between smoking and sleep apnea. Chest. 2014;146(6):1673–1680. doi:10.1378/chest.14-0772. Available at: https://journal.chestnet.org/article/S0012-3692(15)51539-0/abstract. Accessed: 20.02.24
2. Bower, J.E. (2014) ‘Cancer-related fatigue—mechanisms, risk factors, and treatments’, Nature Reviews Clinical Oncology, 11(10), pp. 597–609. doi:10.1038/nrclinonc.2014.127.

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