Abstract Introduction Combustible cigarettes are the leading cause of preventable death in the U.S. Nicotine use prevalence has remained stable among those with chronic health conditions (CHCs) despite national reductions in the general population. This is particularly concerning because many individuals with CHCs, including those with a history of traumatic brain injuries (TBIs), are at greater risk for nicotine and tobacco-related diseases and complications (e.g., cancer, cardiovascular injury). Further, both TBI and nicotine use increase risk for insomnia symptoms. However, despite higher prevalences of nicotine use in populations with CHCs, to our knowledge no work has explored the association of nicotine status and subjective sleep quality in individuals with TBI and insomnia. Methods We analyzed baseline data from a community sample of TBI patients with insomnia (N=48, Mage=39.8 ±12.9, 65% female) enrolled in a parent RCT comparing 4-session CBT-I to sleep education. Participants self-reported combustible tobacco and e-cigarette usage, with 15% (N=7) endorsing current use and 17% (N=8) endorsing former use. A one-way ANOVA with Tukey’s HSD post-hoc analyses examined associations between nicotine use status and subjective sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). Results Subjective sleep quality differed significantly by nicotine use status in individuals with TBI (p=0.012), such that current nicotine use was associated with significantly worse sleep quality compared to former nicotine use (MPSQI: 14.7 vs. 9.9; p=0.009). Though there was no significant difference in overall sleep quality scores between current and never nicotine users (MPSQI: 14.7 vs. 12.5, p=0.2), a greater proportion of current nicotine users reported “moderate-to-extreme difficulties” in sleep quality (100%), sleep latency (100%), and sleep disturbance (86%) than never nicotine users (78%, 88%, and 48%, respectively). Conclusion Individuals with a history of TBI and comorbid insomnia symptoms who currently use nicotine products may report worse sleep quality than former nicotine users. Findings underscore the need for targeted screening and policy efforts to reduce nicotine exposure and increase access to cessation treatments. Nicotine cessation may improve sleep quality among individuals with TBI. Support (if any) AASM Foundation SRA I.
Steffens et al. (Fri,) studied this question.