Deleterious Association of Inhalant Use on Sleep Quality during the COVID-19 Pandemic.

Deepti Gunge,Ira Advani,William Merz,Ana Lucia Fuentes,Sarah J Banks,Shreyes Boddu,Sagar Mehta,Atul Malhotra,Yi Jan Ella Chen,Laura E Crotty Crotty Alexander,Jordan Marganski

doi:10.3390/ijerph182413203

Abstract

The COVID-19 pandemic generated large amounts of stress across the globe. While acute stress negatively impacts health, defining exact consequences and behavioral interventions can be difficult. We hypothesized that a generalized increase in stress and anxiety caused by continuation of the global pandemic would negatively impact sleep quality and that ever users of e-cigarettes and conventional tobacco would have more profound alterations over time. Participants were recruited via social media to complete an online survey in April 2020 (n = 554). Inhalant use was assessed through the UCSD Inhalant Questionnaire and sleep quality was gauged through the Pittsburgh Sleep Quality Index (PSQI). A set of participants (n = 217) retook the survey in June 2020. Inhalant users—historical or current e-cigarette vapers, conventional tobacco smokers, and dual users—had higher PSQI scores than never smoker/never vapers, demonstrating worse sleep quality in inhalant users. Non-smoking/non-vaping subjects who retook the survey in June 2020 had improvement in their PSQI scores by paired t test, indicating better sleep quality as the pandemic continued, while inhalant users of all types had persistently high PSQI scores (poor sleep quality). These data suggest that ever users of tobacco products may be susceptible to overall diminished sleep quality in the setting of stressful life circumstances. These data also suggest that pandemic-initiated lifestyle changes may have led to improvements in sleep quality. Finally, these findings raise concerns for correlations between either past or active e-cigarette use on sleep, and thus overall health.

Highlights

While there is strong evidence linking conventional tobacco use with sleep disturbance, the effects of electronic (e)-cigarettes on sleep quality remain largely unknown
We found that female users of both conventional tobacco and e-cigarettes, known as dual users, had worsened sleep quality and higher sleep latency than never smokers/never vapers [3]
While we have run larger survey-based studies and have found adverse effects of dual use of e-cigarettes and conventional tobacco on certain aspects of sleep [3], the findings presented here suggest that inhalant users may be susceptible to overall diminished sleep quality in the setting of continued stressful life circumstances

Summary

Introduction

While there is strong evidence linking conventional tobacco use with sleep disturbance, the effects of electronic (e)-cigarettes on sleep quality remain largely unknown. We found that female users of both conventional tobacco and e-cigarettes, known as dual users, had worsened sleep quality and higher sleep latency (amount of time to fall asleep) than never smokers/never vapers [3]. This pilot study was replicated in a larger cohort, validating our findings that dual use is associated with increased sleep latency (manuscript in revision).

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Discussion

Conclusion