Insomnia After Quitting Smoking: How Long Will It Last?

The research that we’re about to summarize shows that insomnia is very common after quitting smoking and usually lasts anywhere from 3 weeks to a few months (in the worst cases).

Insomnia leads to side effects that include stress, irritability, headaches, and other symptoms. These happen to be common triggers for smoking in the first place, so the worse someone’s sleep quality is, the harder it is to quit smoking.

In fact, studies have shown that (1):

...poor sleep quality before and during the first week of a quit attempt was associated

with a reduced likelihood of smoking cessation at 4 and 12 weeks

after the initiation of the quit attempt among socioeconomically disadvantaged adults

For a smoker that already has insomnia before they quit, failure rates are even higher (2).

In practical terms, while insomnia should be expected when quitting smoking, it should not be left untreated. The more sleep quality can be improved, it’s likely that the smoker will be successful.

How Common Is Insomnia While Quitting Smoking?

Smoking is already bad for sleep quality, but insomnia is a clinically verified nicotine withdrawal symptom (3).

In other words, it gets worse before it gets better.

What’s interesting is that standard treatment methods (e.g. nicotine patch, medication) still result in really poor success rates of quitting. That points to the fact that the main factor behind failure is something that’s being left untreated; Sleep may be one of those key factors.

So far, research shows that:

• Odds of sleep problems are lowest for people that have never smoked. After enough time has passed, “former smokers” have similar odds of sleep issues as those never smokers. However, smokers have the highest odds of developing sleep issues by far, which only gets worse while trying to quit (4).

• Approximately 42% of smokers trying to quit experience insomnia symptoms. Heavier smokers typically have more severe sleep issues (5).

SummaryInsomnia while quitting smoking is very common due to nicotine withdrawal and other factors.

How Long Does Insomnia While Quitting Smoking Last?

The answer to this question varies a bit depending on what research you look at.

One study found that (same as above):

Most symptoms decreased sharply during the first few days of cessation followed by a continued, but slower rate of decline in the second and third week of abstinence.

That particular study found that most sleep issues were gone after the third week.

Other studies found similar results that the sleep issues started within 24-36 hours of quitting, but mostly gone at the 3 month follow-up (6,7).

However, some research shows that the initial symptoms don’t dissipate until after the first month of quitting (8).

SummaryMost people quitting smoking will experience insomnia shortly after quitting, but will improve over the course of the next month if they maintain abstinence from smoking. However, there are cases where sleep quality is still poor even months after quitting.

Treatment Options for Sleep Trouble While Quitting Smoking

It makes sense to try and treat sleep issues so that they don’t develop into chronic insomnia, and may improve chances of quitting success.

Sleeping aids might help a bit, but they’re not going to be a big part of a treatment plan prescribed by any doctor.

So far, most research has focused on using nicotine replacement therapy (NRT) and sleeping medication.

Unfortunately, these haven’t proved to be very effective.

• NRT isn’t particularly effective, and about 10% of patients can experience NRT-induced sleep disturbances that can last months (9).
• Research has shown that bupropion and varenicline treatment did not improve withdrawal-related sleep disturbance (10).

So while it may be better than nothing for most people, those are not very promising...

Enter cognitive behavioral therapy (CBT). Recent research shows that CBT is effective for almost anyone with sleep trouble, and there’s no significant risk of side effects.

As of now, CBT hasn’t been studied extensively for people quitting smoking.

But there is one study that shows some promise where patients that received CBT-I (CBT for insomnia) found (11):

...improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence.

These were subjects that already had sleep trouble before they quit, so this is an even more impressive result.

Note the second part of that conclusion. Personally, I would’ve expected for those subjects to have a better chance of quitting than the control group, but they didn’t. That’s what other research has suggested, and common sense would say the same.

And this is just one study, but it reinforces that sleep research in this particular still needs to be pushed further to draw firm conclusions.

SummaryCBT appears to be the most promising treatment for improving insomnia symptoms while quitting smoking. Ideally, this should be started even before quitting. However, more research needs to be done on the effectiveness of different potential treatment methods.

Summary: Insomnia and Quitting Smoking

Let me try to sum up what we’ve covered here:

• About half of people quitting smoking experience a sharp decline in sleep quality within the first day or two.
• Sleep quality gradually improves, and eventually gets back to a standard baseline in 3-4 weeks for most people.
• However, insomnia can last for months (even up to a year for some according to some research).
• Heavier smokers are more likely to have sleep issues.
• CBT appears to be the best treatment method, although nicotine replacement therapy may also have some effectiveness depending on the individual.

Quitting smoking is very hard to do, and sleep issues will likely only make it harder. It’s a problem that anyone thinking of quitting should approach with a doctor to try to improve their chances of success.

References

1. The influence of sleep quality on smoking cessation in socioeconomically disadvantaged adults
2. Insomnia symptoms as a risk factor for cessation failure following smoking cessation treatment
3. Signs and Symptoms of Tobacco Withdrawal
4. Sleep disturbances associated with cigarette smoking
5. Reports of smoking withdrawal symptoms over a 21 day period of abstinence
6. Effects of Abstinence From Smoking on Sleep and Daytime Sleepiness
7. Sleep changes in smokers before, during and 3 months after nicotine withdrawal
8. Long-Term Changes in Sleep and Depressive Symptoms of Smokers in Abstinence
9. Predictors and Timing of Adverse Experiences During Transdermal Nicotine Therapy
10. Sleep Disturbance During Smoking Cessation: Withdrawal or Side Effect of Treatment?
11. Integrating a Behavioural Sleep Intervention into Smoking Cessation Treatment for Smokers with Insomnia