Sleep disorders and secondhand smoke exposure in the U.S. population

Sleep disorders in the United States are pervasive and have been linked to increased risk of injury, morbidity, and mortality. Smoking is a known risk factor for sleep disorders; the association between secondhand smoke (SHS) exposure and sleep disorders is less clear. We sought to examine the relationship between SHS exposure and sleep disorders among a representative sample of U.S. adults (n = 4,123).

Data were from the 2005-2006 National Health and Nutrition Examination Survey. Multivariable logistic regression models examined the association between both smoking and SHS exposure with two measures of sleep disorder (i.e., self-reported health care provider diagnosis and self-report of two or more sleep symptoms). SHS exposure status was based on a combination of self-report and serum cotinine levels.

Relative to nonsmokers without SHS exposure, smokers were significantly more likely to have been diagnosed with a sleep disorder (odds ratio [OR] = 1.73 [95% CI = 1.16-2.60]) and more likely to report at least two sleep disorder symptoms (OR = 1.42 [95% CI = 1.09-1.84]). SHS-exposed nonsmokers were not significantly more likely to report a sleep disorder or sleep symptoms (OR = 1.43 [95% CI = 0.79-2.57] and OR = 1.03 [95% CI = 0.83-1.27]), respectively.

Although smoking appears to play an important role in the prevalence of sleep disorders in the U.S. adult population, the role of SHS exposure is inconclusive and warrants further investigation.