Abstract Introduction/AimIntroduction Sleep plays a critical role in maintaining cognitive, emotional, and physical health. Disruptions to sleep have been linked to various adverse health outcomes. With the growing popularity of electronic cigarettes (e-cigarettes), there is increasing concern about their impact on sleep outcomes. Aim This systematic review aims to examine the association between exclusive nicotine-based e-cigarette use and sleep-related outcomes. Method A comprehensive search was conducted in PubMed and EMBASE up to 21st January 2025, adhering to PRISMA guidelines. Studies were included if they examined sleep outcomes in exclusive e-cigarette users, excluding dual users of combustible tobacco. Sleep measures were categorized using Buysse’s multidimensional sleep health framework. Quality appraisal was conducted using the CASP checklist. Results Fourteen studies met inclusion criteria. Most showed that current e-cigarette users had higher odds of insufficient sleep OR 1.33–1.57 and poorer sleep quality OR 1.29–2.16 compared to non-users. Evidence regarding former users was mixed, suggesting a possible reversal of effects upon cessation. Limited evidence was found for associations between e-cigarette use and diagnosed sleep disorders. Conclusion Exclusive e-cigarette use is associated with inadequate sleep and poorer sleep quality. These findings highlight the need for public health interventions, clinical screening for sleep disturbances in e-cigarette users, and further longitudinal studies using objective sleep measures. This abstract is funded by: None
Thng et al. (2026) studied this question.