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Impact of Nicotine and Other Stimulants on Sleep in Young Adults

Caviness, Celeste M., PhD; Anderson, Bradley J., PhD; Stein, Michael D., MD

doi: 10.1097/ADM.0000000000000481
Original Research

Objectives: Sleep problems can have long-term negative consequences. This study explored the relationship of commonly used stimulant substances to poor sleep quality in young adults.

Methods: We surveyed 498 participants, aged 18 to 25, who reported recent alcohol or marijuana use. Stimulant substances measured included coffee, energy drinks, nonmedical prescription stimulants (NPS), cocaine, and nicotine. Sleep outcomes were measured using the Pittsburgh Sleep Quality Index (PSQI) and its components.

Results: Participants averaged 21.3 (±2.07) years of age, 47.8% male, 65.5% non-Latino white, 10.8% African-American, 12.3% Latino, and 11.5% other ethnic origins. In the past 30 days, 24.9% had used cigarettes, 48.1% energy drinks, 17.3% NPS, 79.3% coffee, and 7.9% cocaine. Mean PSQI global score was 6.21 (±3.66, median = 5). After adjusting for background characteristics, PSQI global scores were positively and significantly associated with number of cigarettes/day (b = 0.16, 95% confidence interval 0.07 to 0.25, P < 0.001) and days of NPS (b = 0.10, 95% confidence interval 0.01 to 0.18, P = 0.030).

Conclusions: NPS negatively affects sleep, but nicotine is particularly deleterious to sleep quality. Addressing smoking cessation to improve sleep may be a novel way to motivate young adult smokers to quit.

Behavioral Medicine and Addiction Research Unit, Butler Hospital, Providence, RI (CMC, BJA, MDS); Health Law, Policy & Management, Boston University School of Public Health, Boston, MA (MDS).

Send correspondence to Michael D. Stein, MD, Department of Health Law, Policy & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118. E-mail:

Received 21 May, 2018

Accepted 30 October, 2018

This work was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (grant number R01AA020509).

The NIAAA had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. This trial is registered at; clinical trial # NCT01473719.

The authors report no conflicts of interest.

© 2019 American Society of Addiction Medicine