Matthew is an associate editor of The American Journal of Managed Care® (AJMC®). He has been working on AJMC® since 2019 after receiving his Bachelor's degree at Rutgers University–New Brunswick in journalism and economics.
Former e-cigarette users were found to be more likely to report sleep deprivation compared with never users, according to study findings.
As the researchers note, e-cig usage has risen exponentially in the United States in recent years, with the highest prevalence exhibited among young adults aged 18 to 24. Several adverse health outcomes have been linked with e-cig usage in the past, such as increased heart rate, cough and wheeze, endothelial dysfunction, oxidative stress, addiction, and attention deficiency. Moreover, vaping has emerged as a risk factor for coronavirus disease 2019 in teens and young adults.
In addition to increased e-cig usage, one-third of US young adults do not get enough sleep. The contents of e-cig vapor, particularly nicotine, may cause sleep deprivation, note the researchers, but few studies have evaluated this association.
“It is important to understand whether e-cig use causes sleep deprivation among young adults because the e-cig use prevalence is increasing in this population and many adverse health outcomes are linked to sleep deprivation,” stated the authors.
Examining the link between sleep deprivation and e-cig usage, the researchers conducted a cross-sectional study using nationally representative data from the Behavioral Risk Factor Surveillance System (BRFSS). The study recruited American young adults from the 2017 and 2018 BRFSS who performed e-cig and sleep modules in the interview (N = 19,701). The study cohort was reduced to 18,945 in the crude analysis after removing participants who had missing exposure and outcome values.
The relationship between e-cig use and sleep deprivation was tested via poisson regression models, with data adjusted for sociodemographic variables, physical activity, mental health, body mass index, smokeless tobacco products use, alcohol drinking, and smoking.
Among those of the 2017 BRFSS cohort, the weighted prevalence of ever having used e-cigs was 38.9% (95% CI, 37.9%-40.0%) and the weighted prevalence of current e-cig use was 10.0% (95% CI, 9.3%-10.6%). Both these values increased in 2018, with 47% (95% CI, 45.6%-48.4%) of young adults indicated as having used e-cigs and 15.7% (95%CI, 14.7%-16.7%) found to be current e-cig users.
The weighted prevalence values of sleep deprivation in these cohorts were similar from 2017 (34.2%; 95% CI, 31.9%-36.5%) to 2018 (34.3%; 95% CI, 33.3%-35.4%).
In assessing the pooled data set, the weighted prevalence of current e-cig use and self-reported sleep deprivation was 47%, with 35% of former users also reporting sleep deprivation. After adjusting for the variables previously referenced, former e-cig users were 1.17 (95% CI, 1.06-1.29) times more likely to report sleep deprivation compared with never users. For everyday users, the prevalence ratio for self-reported sleep deprivation ballooned to 1.42 (95% CI, 1.23-1.65) compared with never users.
“These findings suggest that e-cig use might be related to sleep deprivation in young adults,” conclude the study authors. “Future longitudinal studies should assess the causal and dose–response nature of this relationship.”
Kianersi S, Zhang Y, Rosenberg M, Macy JT. Association between e-cigarette use and sleep deprivation in US young adults: results from the 2017 and 2018 Behavioral Risk Factor Surveillance System. Addict Behav. Published online September 6, 2020. doi:10.1016/j.addbeh.2020.106646