The association between sleep disturbance and second-hand smoke exposure: a large-scale, nationwide, cross-sectional study of adolescents in Japan

Short sleep duration and smoking initiation in university students: a retrospective cohort study

PURPOSE

The aim of this study was to clarify an association between short sleep duration and smoking initiation.

METHODS

Participants eligible for this retrospective cohort study were university students who were admitted to a single national university in Japan between 2007 and 2015. Baseline sleep duration and smoking status were measured using general questionnaires at health checkups at admission. During a 6-year observation period, smoking initiation was assessed using general questionnaires at annual health checkups. Cox proportional hazards models adjusted for clinically relevant factors were used to assess the association between sleep duration and smoking initiation.

RESULTS

Of 17,493 men, including 540, 5,568, 8,458, 2,507, and 420 men with sleep duration of < 5, 5-6, 6-7, 7-8, and ≥ 8 h, respectively, smoking initiation was observed in 16.1%, 12.5%, 11.2%, 10.0%, and 11.7%, respectively, during a median observation period of 3.0 years. Men with shorter sleep duration were at a higher risk of smoking initiation (adjusted hazard ratio 1.49 [95% confidence interval 1.19-1.85], 1.11 [1.01-1.22], 1.00 [reference], 0.92 [0.80-1.06], and 1.00 [0.75-1.34], respectively). Of 8,880 women, including 267, 3,163, 4,220, and 1,230 women with sleep duration of < 5, 5-6, 6-7, and ≥ 7 h, respectively, smoking initiation was observed in 4.9%, 2.3%, 2.0%, and 2.2%, respectively, during a median observation period of 3.0 years. A similar dose dependent association was ascertained in women (2.50 [1.39-4.49], 1.18 [0.86-1.62], 1.00 [reference], and 1.22 [0.79-1.89], respectively).

CONCLUSION

This study clarified that university students with short sleep duration were vulnerable to smoking initiation.

Associations of exposure to volatile organic compounds with sleep health and potential mediators: analysis of NHANES data

Objective

The effect of environmental pollution on sleep has been widely studied, yet the relationship between exposure to volatile organic compounds (VOCs) and sleep health requires further exploration. We aimed to investigate the single and mixed effect of urinary VOC metabolites on sleep health and identify potential mediators.

Methods

Data for this cross-sectional study was collected from the National Health and Nutrition Examination Surveys (NHANES) (2005-2006, 2011-2014). A weighted multivariate logistic regression was established to explore the associations of 16 VOCs with four sleep outcomes. Following the selection of important VOCs through the least absolute shrinkage and selection operator (LASSO) regression, principal component analyses (PCA), weight quantile sum (WQS), and Bayesian kernel machine regression (BKMR) analyses were conducted to explore the associations between exposure to single and mixed VOCs and sleep outcomes, as well as identify the most contributing components. A mediation analysis was performed to explore the potential effect of depression scores.

Results

Of the 3,473 participants included in the study, a total of 618 were diagnosed with poor sleep patterns. In logistic regression analyses, 7, 10, 1, and 5 VOCs were significantly positively correlated with poor sleep patterns, abnormal sleep duration, trouble sleeping, and sleep disorders, respectively. The PCA analysis showed that PC1 was substantially linked to a higher risk of poor sleep patterns and its components. The WQS model revealed a positive association between VOC mixture of increased concentrations and poor sleep patterns [OR (95% CI): 1.285 (1.107, 1.493)], abnormal sleep duration [OR (95% CI): 1.154 (1.030, 1.295)], trouble sleeping [OR (95% CI): 1.236 (1.090, 1.403)] and sleep disorders [OR (95% CI): 1.378 (1.118, 1.705)]. The BKMR model found positive associations of the overall VOC exposure with poor sleep patterns, trouble sleeping, and sleep disorders. PCA, WQS, and BKMR models all confirmed the significant role of N-acetyl-S-(N-methylcarbamoyl)-l-cysteine (AMCC) in poor sleep patterns and its components. The depression score was a mediator between the positive VOC mixture index and the four sleep outcomes.

Conclusion

Exposure to single and mixed VOCs negatively affected the sleep health of American population, with AMCC playing a significant role. The depression score was shown to mediate the associations of VOC mixtures with poor sleep patterns and its components.

Association of Sleep Quality and General, Mental, and Oral Health with Lifestyle Traits (Dietary Intake, Smoking Status) in Arthritis: A Cross-Sectional Study from the Canadian Community Health Survey (CCHS)

Arthritis is associated with health challenges. Lifestyle traits are believed to influence arthritis development and progression; however, data to support personalized treatment regimens based on holistic lifestyle factors are missing. This study aims to provide a comprehensive list of associations between lifestyle traits and the health status of individuals with arthritis in the Canadian population, using binary logistic regression analysis on data from the Canadian Community Health Survey, which includes 104,359 respondents. Firstly, we explored the association between arthritis and various aspects of health status including self-reported lifestyle factors. Secondly, we examined the associations between self-reported dietary intake and smoking status with general, mental, and oral health, and sleep disturbance among individuals both with and without arthritis. Our analysis revealed that individuals with arthritis reported considerably poorer general, mental, and oral health, and poorer sleep quality compared to those without arthritis. Associations were also found between self-reported dietary intake and various measures of health status in individuals with arthritis. Smoking and exposure to passive smoking were associated not only with arthritis but also with compromised sleep quality and poorer general, mental, and oral health in people with and without arthritis. This study highlights the need for personalized and holistic approaches that may include a combination of dietary interventions, oral health improvements, sleep therapies, and smoking cessation for improved arthritis prevention and care.

Association of second-hand smoking with sleep quality among adults in Ibadan, Nigeria: a cross-sectional evaluation of data from the COMBAT-CVDs study

PURPOSE

Sleep quality (SQ) is essential in the overall well-being and quality of life, but little is known about the association of secondhand smoking (SHS) with SQ. This study assessed the relationship between SHS and SQ among adults who had never smoked in Ibadan, Nigeria.

METHODS

We identified 3193 respondents who had never smoked or used any form of tobacco product in the Community-based Investigation of the Risk Factors for Cardiovascular Diseases in the Ibadan and suburbs (COMBAT-CVDs) study. SHS was self-reported, SQ assessed using a sleep quality scale, and SQ scores were classified by the quartile distributions of SQ scores in this sample as good (< 7), moderate (7-13), fair (14-20), and poor (≥ 21), and logistic regression models were used to estimate the multivariable-adjusted odds ratio and 95% confidence interval (CI) of the association between SHS and SQ in a two-sided test at P < 0.05.

RESULTS

The mean (SD) of age in this sample was 34.8 ± 15.1 years; 1621 (50.8%) were females, and 848 (26.6%) experienced SHS. The multivariable-adjusted odds by categories of SQ scores (using good SQ as reference) in the light of SHS were OR: 1.64 (95%CI 1.28, 2.12) for moderate SQ, OR: 1.88 (95%CI 1.46, 2.42) for fair SQ and OR: 2.14 (95%CI 1.66, 2.75) for poor SQ; P < 0.0001 after adjusting for relevant covariates. The sex- and age groups- stratified analyses revealed similar trends.

CONCLUSION

SHS is associated with higher odds of poor SQ in this study. Culturally relevant interventions for mitigating exposure to SHS might improve SQ and overall quality of life, particularly among vulnerable populations.

Tobacco Smoke Exposure and Sleep Duration among U.S. Adolescents

OBJECTIVES

Tobacco smoke exposure (TSE) and poor sleep are public health problems with their own set of consequences. This study assessed whether TSE was associated with sleep duration among U.S. adolescents.

METHOD

We conducted a secondary analysis of 2013-2018 National Health and Nutrition Examination Survey data including 914 nontobacco-using adolescents ages 16-19 years. TSE measures included cotinine and self-reported home TSE groups including no home TSE, thirdhand smoke (THS) exposure, and secondhand smoke (SHS)+THS exposure. Sleep duration was assessed in hours and categorically as insufficient sleep (recommended hours). Weighted multiple linear regression and multinomial regression models were conducted.

RESULTS

Adolescents with higher log-cotinine levels had higher number of sleep hours (β = 0.31, 95%CI = 0.02,0.60) and were at increased odds of reporting excess sleep (AOR = 1.41, 95%CI = 1.40,1.42), but were at reduced odds of reporting insufficient sleep (AOR = 0.88, 95%CI = 0.87,0.89). Compared to adolescents with no home TSE, adolescents with home THS exposure and home SHS+THS exposure were at increased odds of reporting insufficient sleep (AOR = 2.27, 95%CI = 2.26,2.29; AOR = 2.75, 95%CI = 2.72,2.77, respectively) and excess sleep (AOR = 1.89, 95%CI = 1.87,1.90; AOR = 5.29, 95%CI = 5.23,5.34, respectively).

CONCLUSIONS

TSE may affect insufficient and excess sleep duration among adolescents. Eliminating TSE may promote adolescent respiratory and sleep health.

The association between passive smoking and sleep quality in a Chinese hypertensive population: A cross-sectional study

INTRODUCTION

This study evaluates the association between passive smoking, specifically secondhand smoke (SHS) and thirdhand smoke (THS) exposure, and sleep quality in a hypertensive population.

METHODS

We enrolled 1427 eligible hypertensive patients from a 2022 national cross-sectional survey in China. Data on tobacco smoke exposure and sleep were collected via questionnaires. Multiple logistic regression and linear regression were employed to assess the relationship between passive smoking and sleep quality characteristics, as well as the correlation between passive smoking exposure characteristics and sleep quality.

RESULTS

Among 589 hypertensive patients with no tobacco smoke exposure, 679 exposed to SHS, and 159 exposed to THS, SHS exposure was associated with a higher risk of poor sleep quality, even after adjusting for potential confounding factors (β=0.10; 95% CI: 0.32-0.95). No significant relationship was observed between THS exposure and sleep quality. SHS exposure was associated with various sleep quality characteristics, including shorter sleep duration (AOR=1.71; 95% CI: 1.06-2.76) and increased frequency of 1-2 sleep disturbances per week (AOR=1.68; 95% CI: 1.25-2.26). Individuals exposed to SHS were more likely to experience poorer subjective sleep quality (AOR=1.53; 95% CI: 1.07-2.21) and have sleep efficiency <65% (AOR=1.82; 95% CI: 1.22-2.71). Exposure to passive smoking at home, in the community, in public places, exposure to passive smoking with family and friends, and increased frequency of exposure, were all associated with a higher risk of poor sleep quality.

CONCLUSIONS

Our study suggests that SHS exposure in hypertensive populations is associated with poor sleep quality and various characteristics of sleep quality. No significant association was found between THS exposure and sleep quality. These findings underscore the need to enhance tobacco control efforts in China, particularly for individuals with chronic diseases, to safeguard public health.

Tobacco smoking, second-hand smoking exposure in relation to psychotic-like experiences in adolescents

BACKGROUND

Previous literature supports that tobacco smoking and second-hand smoking (SHS) exposure were strongly associated with poor mental health in the general population. However, there is a lack of empirical data on the relationship between tobacco smoking, SHS exposure and psychotic-like experiences (PLEs). This study conducted a cross-sectional survey to explore PLEs and the associations of PLEs with tobacco smoking and SHS exposure among adolescents in China.

METHODS

A total sample of 67 182 Chinese adolescents were recruited from Guangdong province in China (53.7% boys, mean age = 12.79 years) from December 17 to 26, 2021. All adolescents have completed self-reported questionnaires on demographic characteristics, smoking status, SHS exposure and PLEs.

RESULTS

Within the sample, only 1.2% of participants had an experience of tobacco smoking while approximately three-fifths reported being exposed to SHS. 10.7% of adolescents reported frequent PLEs over the past month. Adolescents who smoked showed a higher prevalence of PLEs than in non-smoking samples. After controlling for confounders, SHS exposure was a robust risk factor for PLEs with or without the effect of tobacco smoking.

DISCUSSION

These findings support the importance of smoke-free legislation, and anti-smoking measures in educational settings directed at both adolescents and their caregiver, which may decrease occurring rates of PLEs among adolescents.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications

Secondhand smoke (SHS) is a well-established cause of lung cancer, respiratory disease, heart disease and developmental issues in children, with an overwhelming evidence base spanning over four decades. In this narrative review, we describe studies which have also linked self-reported or cotinine-assessed SHS exposure in the home, workplace and other settings to mental health disorders including depression, suicide, anxiety, and psychological distress in children and adults, sleeping disorders, Attention Deficit Hyperactivity Disorder and behavioural issues in children, and dementia in older adults. In general, evidence indicates that SHS exposure is associated with these disorders in a dose-response manner, with higher odds reported in people who are exposed to SHS at high levels, frequently, and in the home environment. Most studies so far are cross-sectional albeit in large, nationally representative samples from various countries with a smaller number of longitudinal studies. More research is needed in this area to determine whether SHS is a direct cause of adverse mental health outcomes, and whether creating smokefree environments leads to improved mental wellbeing. In particular, more research is needed on the impact of smokefree home environments, an area which has received relatively little focus in smokefree interventions which generally target public places.

Effects of chronic secondhand smoke exposure on cardiovascular regulation and the role of soluble epoxide hydrolase in mice

Background: Secondhand smoke (SHS) is a significant risk factor for cardiovascular morbidity and mortality with an estimated 80% of SHS-related deaths attributed to cardiovascular causes. Public health measures and smoking bans have been successful both in reducing SHS exposure and improving cardiovascular outcomes in non-smokers. Soluble epoxide hydrolase (sEH) inhibitors have been shown to attenuate tobacco exposure-induced lung inflammatory responses, making them a promising target for mitigating SHS exposure-induced cardiovascular outcomes. Objectives: The objectives of this study were to determine 1) effects of environmentally relevant SHS exposure on cardiac autonomic function and blood pressure (BP) regulation and 2) whether prophylactic administration of an sEH inhibitor (TPPU) can reduce the adverse cardiovascular effects of SHS exposure. Methods: Male C57BL/6J mice (11 weeks old) implanted with BP/electrocardiogram (ECG) telemetry devices were exposed to filtered air or 3 mg/m3 of SHS (6 hr/d, 5 d/wk) for 12 weeks, followed by 4 weeks of recovery in filtered air. Some mice received TPPU in drinking water (15 mg/L) throughout SHS exposure. BP, heart rate (HR), HR variability (HRV), baroreflex sensitivity (BRS), and BP variability were determined monthly. Results: SHS exposure significantly decreased 1) short-term HRV by ∼20% (p < 0.05) within 4 weeks; 2) overall HRV with maximum effect at 12 weeks (-15%, p < 0.05); 3) pulse pressure (-8%, p < 0.05) as early as week 4; and 4) BRS with maximum effect at 12 weeks (-11%, p < 0.05). Four weeks of recovery following 12 weeks of SHS ameliorated all SHS-induced cardiovascular detriments. Importantly, mice exposed to TPPU in drinking water during SHS-related exposure were protected from SHS cardiovascular consequences. Discussion: The data suggest that 1) environmental relevant SHS exposure significantly alters cardiac autonomic function and BP regulation; 2) cardiovascular consequences from SHS can be reversed by discontinuing SHS exposure; and 3) inhibiting sEH can prevent SHS-induced cardiovascular consequences.

Passive smoking and insomnia in rural Chinese nonsmoking housewives: An environmental and genetic perspective

Active smoking has been a risk factor for insomnia, however, little is known about the effect of passive smoking on insomnia. Polycyclic aromatic hydrocarbons (PAHs) are potential contents in tobacco smoke. We aimed to investigate the association between passive smoking exposure and insomnia, plus the modification effects of single nucleotide polymorphisms (SNPs) related to PAHs metabolism. A cross-sectional study with 392 nonsmoking women was conducted in a rural area of Shanxi Province, China. A structured questionnaire was used to collect the information on passive smoking exposure, insomnia and other health-related factors via face-to-face interviews. We simultaneously collected participants' hair samples to measure the concentrations of 26 PAHs. Whole blood samples were collected to test 9 SNPs related to PAHs metabolism. Logistic regression analysis was conducted to evaluate the association between passive smoking and insomnia, as well as the relation between passive smoking and PAHs concentrations. We further examined the potential interaction effects between passive smoking and SNPs on insomnia. 118 (30.1 %) were exposed to passive smoking and 128 (32.7 %) suffered from insomnia. Passive smoking nearly doubled the probability of insomnia with adjusted odds ratio and 95 % confidence interval of (1.99: 1.16, 3.39). Dose-response association between passive smoking and insomnia was observed by passive smoking frequency (P trend < 0.001). Among the 7 PAHs measured with detection rates > 70 %, no specific PAH was detected to be associated with passive smoking exposure after Bonferroni correction. The mutant genotypes of CYP1B1 (rs1056836), AHR (rs2066853), and AHRR (rs2292596) were detected to have synergetic effects with passive smoking on insomnia after multivariate adjustment. We found a positive association between passive smoking status and insomnia among nonsmoking women. This association could be modified by SNPs related to PAHs metabolism. PAHs might not be the environmentally potential mechanism involved in the insomnia caused by tobacco smoke exposure.

The relationship between secondhand smoking exposure and mental health among never-smoking adolescents in school: Data from the Global School-based Student Health Survey

BACKGROUND

There is no safe level of exposure to secondhand smoking. Adolescence is a stage of rapid psychological development and is highly susceptible to various factors that can cause some mental health problems. This study aims to estimate the prevalence of secondhand smoking exposure in never-smoking school adolescents and evaluate whether there is an association between secondhand smoking exposure and mental health.

METHODS

70 nationally representative data sets from the Global School-based Student Health Survey, conducted between 2003 and 2017, were used to estimate the prevalence of secondhand smoking exposure and evaluate whether there is an association between secondhand smoking exposure and loneliness, sleeplessness, and suicidal ideation.

RESULTS

Total 191, 613 no-smoking school adolescents (43.0% boys) were included in this analysis. The prevalence of secondhand smoking exposure ranged from 15.1% in Tajikistan to 79.6% in Timor-Leste. There was no difference in the prevalence of secondhand smoking exposure between boys and girls in most countries. After adjusted, secondhand smoking exposure was positively associated with loneliness (odds ratio 1.39, 95% CI 1.30-1.49), sleeplessness (odds ratio 1.37, 95% CI 1.28-1.47), and suicidal ideation (odds ratio 1.22, 95% CI 1.15-1.30) in never-smoking school adolescents in overall samples.

LIMITATIONS

Use of self-report measures and potentially limited generalizability.

CONCLUSIONS

Secondhand smoking exposure remains a serious public health issue among never-smoking school adolescents and its impact on adolescent mental health cannot be ignored. Stricter and more comprehensive policies and bans on secondhand smoking should be implemented, and adolescents' mental health should receive more attention.

Quality of life and sleep disorders in Tehran Employees Cohort (TEC); Association with secondhand smoking and wealth index

PURPOSE

Second-hand smoke is recognized as a major indoor pollutant. Evidences indicated that Second-hand smoke exposure can influence on not only physical health, but also mental well-being. As the correlation of secondhand smoke exposure with sleep quality and quality of life has not yet been clarified sufficiently, the purpose of this study was to evaluate the association between Second-hand smoke exposure, with sleep quality and quality of life after adjusting for active smoking and other relevant confounders.

METHODS

The participants of this study were 1790 staff in Tehran University of Medical Sciences with different jobs employed in various academic departments (clinical, research, services, educational and technical ones). They participated voluntarily in this research project and completed the informed consent form between 2018 and 2019. A translated questionnaire of Global Adult Tobacco Survey was used to gather information about smoke exposure. When to evaluate the quality of life, the WHOQOL-BREF tool was applied. All statistical analyses were executed using STATA V14 software.

RESULTS

High rate of smoking and also exposure to second-hand smoke significantly increased sleep disorder and reduced the quality of life. In other words, smokers or those who are exposed to second-hand smoke suffer from sleep disturbances and had a poorer physical, psychological, and environmental quality of life. Additionally, the results of multivariate regression analysis demonstrated that the secondhand-smoke group had 1.38 times higher rate of sleep disorder in comparison with non-smokers, that was statistically significant. The women had 2.68 times higher odds of having sleep disorder compared to men. (95 % CI: 2.20 to 3.27). On the other hand, mean score of psychological domain of quality of life in secondhand-smoke group was lower with the size of difference as 0.66 than that in non-smokers, and the difference was statistically significant (p = 0.001).

CONCLUSIONS

Both active smoking and exposure to second hand smoke have a negative impact on sleep quality and quality of life.

Secondhand smoke is associated with poor sleep quality in self-reported never-smokers of Northwest China: a cross-sectional study

OBJECTIVE

To investigate the relationship between secondhand smoke (SHS) exposure and sleep quality in never-smokers of Northwest China.

METHODS

Never-smoking adults (≥ 15 years) from Xinjiang, Northwest China, were included in this cross-sectional survey between April and October 2019. SHS exposure in never-smokers was estimated using a structured questionnaire. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI), with PSQI score > 5 classified as poor sleep quality. Association of SHS exposure and frequency and duration of SHS exposure with poor sleep quality were analyzed by using a multivariate logistic regression after adjusting for potential confounding factors, including stratification by sex.

RESULTS

The mean age of participants was 48.0 years, and 77% were females. Of 21,198 never-smokers, 13% (n = 2703) reported SHS exposure and 35% (n = 7390) reported poor sleep quality. In multivariate logistic regression analysis, a significant association was observed between SHS exposure and poor sleep quality (adjusted odds ratio (OR), 1.36; 95% confidence interval (CI) 1.24-1.48). Subgroup analysis showed a negative association of SHS exposure with sleep quality in both sexes. However, a significant dose-response relationship of frequency and duration of SHS exposure per week with poor sleep quality was observed only in females. Consistent results were also observed in the aged ≥ 18 years.

CONCLUSION

Exposure to SHS is associated with poor sleep quality in never-smoking adults of Northwest China. A dose-response relationship between SHS exposure and poor sleep quality is found in women. Avoiding SHS exposure may have beneficial effects on sleep quality, especially for females.

Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications

Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.

Effects of Cannabis Consumption on Sleep

Despite the fact that medical properties of Cannabis have been recognized for more than 5000 years, the use of Cannabis for medical purposes have recently reemerged and became more accessible. Cannabis is usually employed as a self-medication for the treatment of insomnia disorder. However, the effects of Cannabis on sleep depend on multiple factors such as metabolomic composition of the plant, dosage and route of administration. In the present chapter, we reviewed the main effect Cannabis on sleep. We focused on the effect of "crude or whole plant" Cannabis consumption (i.e., smoked, oral or vaporized) both in humans and experimental animal models.The data reviewed establish that Cannabis modifies sleep. Furthermore, a recent experimental study in animals suggests that vaporization (which is a recommended route for medical purposes) of Cannabis with high THC and negligible CBD, promotes NREM sleep. However, it is imperative to perform new clinical studies in order to confirm if the administration of Cannabis could be a beneficial therapy for the treatment of sleep disorders.

Associations Between Secondhand Smoke and Mental Health in Korean Adolescents

This study assessed secondhand smoke exposure among nonsmokers and examined its association with mental health in Korean adolescents. We used the 14th Korea Youth Risk Behavior Survey in 2018 to extract data and analyzed 60 040 adolescents through three secondhand smoke exposure categories: home, school, and public places. Mental health included stress, insufficient sleep, depressive symptoms, and suicidal ideation. Secondhand smoke exposure was reported at 23.0% for home, 20.0% for school, and 51.4% for public places. Secondhand smoke exposures were associated with stress insufficient sleep, depressive symptoms, and suicidal ideation. Furthermore, in the stratified analysis, secondhand smoke exposure was related to poor mental health in both nonsmokers and smokers. Based on the results, we concluded that Korean adolescents may experience poor mental health symptoms from being exposed to secondhand smoke.

Dampness and mold at home and at work and onset of insomnia symptoms, snoring and excessive daytime sleepiness

AIM

To investigate whether exposure to dampness and mold at home and at work induce sleep disturbances and daytime sleepiness among adults.

MATERIALS AND METHODS

Associations between onset of sleep disturbances and dampness, mold and mold odor at home and at work were investigated in a cohort of 11,318 adults from the population in Iceland, Norway, Sweden, Denmark and Estonia. The participants answered a questionnaire at baseline and 10 years later, with questions on sleep disturbances, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), insomnia symptoms, snoring and excessive daytime sleepiness (EDS). Multiple logistic regression models were applied to estimate associations adjusting for potential confounders including gender, age, smoking habit at baseline, change of smoking habit from baseline to follow up, BMI at baseline, change of BMI from baseline to follow up, education level at follow up, allergic rhinitis at baseline, doctor diagnosed asthma at baseline and chronic bronchitis at baseline.

RESULTS

Baseline floor dampness, visible mold and mold odor at home increased onset of DIS, DMS, EMA, insomnia symptoms and snoring during follow up (OR 1.29-1.87). Any sign of dampness at baseline increased onset of DIS (OR 1.28, 95%CI 1.06-1.55), DMS (OR 1.17, 95%CI 1.02-1.34) and insomnia symptoms (OR 1.18, 95%CI 1.03-1.36). Dampness at home during follow up increased onset of DIS, DMS, EMA, insomnia symptoms and EDS (OR 1.17-1.36). Dampness at work during follow up increased onset of DIS, EMA, insomnia symptoms and EDS (OR 1.16-1.34). Combined dampness at home and at work during follow up increased the risk of onset of DIS, DMS, EMA, insomnia symptoms and EDS (OR 1.29-1.74).

CONCLUSIONS

Dampness and mold at home and at work can increase the development of insomnia symptoms, snoring and EDS among adults.

The association between exposure to second-hand smoke and sleep disturbances: A systematic review and meta-analysis

OBJECTIVE

To investigate the association between second-hand smoke (SHS) exposure and sleep disturbances by systematically reviewing the literature base and to quantify this association by conducting a meta-analysis.

METHOD

We did a systematic search of five databases- PubMed, Embase, CINAHL Plus, Web of Science - Core Collection, and Google Scholar. The primary outcomes were short sleep duration (SSD), poor sleep quality (PSQ), and excessive daytime sleepiness (EDS).

RESULT

Our systematic search yielded a total of 1623 studies. However, 12 studies qualified for qualitative synthesis and 11 studies (12 surveys) with adequate information were included in the meta-analysis involving 730,808 participants. All the studies were cross-sectional. We found an association between SHS exposure and SSD [pooled OR: 1.20 (95% CI, 1.09-1.33; p = 0.0003; I²= 68%), N = 7]; EDS [pooled OR: 1.07 (95% CI, 1.01-1.13; p = 0.02; I² = 0%), N = 4]; and PSQ [pooled OR: 1.12 (95% CI, 1.01-1.23; p = 0.03; I² = 79%), N = 10]. Subgroup analyses suggest significant association between SHS exposure and PSQ among adolescents. However, no such association was observed among adults. In addition, no significant association was observed between PSQ and SHS exposure when biomarker was used to identify SHS exposure.

CONCLUSION

This study is the first systematic review and meta-analysis to examine the association between SHS exposure and sleep outcomes. Self-reported exposure to SHS is positively associated with SSD, EDS, and PSQ, although the effects are modest. Further studies with robust methodology to ascertain exposure information are warranted to further elucidate the relationship between SHS exposure and sleep disturbances.

Effects of fixed oil of Caryocar coriaceum Wittm. Seeds on the respiratory system of rats in a short-term secondhand-smoke exposure model

ETHNOPHARMACOLOGICAL RELEVANCE

Pequi fruit are obtained from the pequi tree (Caryocar coriaceum), from which the pulp and nut are used in order to extract an oil that is commonly used in popular medicine as an antiinflammatory agent, particularly for the treatment of colds, bronchitis and bronchopulmonary infections. Making use of the fixed oil of Caryocar coriaceum (FOCC), an attractive alternative for the treatment of diseases caused by exposure to environmental tobacco smoke.

AIM OF THE STUDY

To evaluate whether oral intake FOCC provides beneficial effects in the respiratory system of rats submitted to a short-term secondhand smoke (SHS) exposure model.

MATERIALS AND METHODS

The experiments were performed on Wistar rats divided into 4 groups; in the SHS + O and SHS + T groups, the animals were pretreated orally with 0.5 mL of FOCC (SHS + O) or vehicle (Tween-80 [1%] solution) (SHS + T). Immediately after pretreatment, the animals were submitted to the SHS exposure protocol, for a total period of 14 days. Exposures were performed 6 times per day, with a duration of 40 min per exposure (5 cigarettes per exposure), followed by a 1-h interval between subsequent exposures. In the AA + O and AA + T groups, animals were submitted to daily oral pretreatment with 0.5 mL of FOCC (AA + O) or vehicle (AA + T). These animals were then subjected to the aforementioned exposure protocol, but using ambient air. After the exposure period, we investigated the effects of FOCC in respiratory mechanics in vivo (Newtonian resistance -R_N, tissue elastance -H, tissue resistance -G, static compliance -C_ST, inspiratory capacity -IC, PV loop area) histopathology and lung parenchymal morphometry in vitro (polymorphonuclear cells -PMN, mean alveolar diameter -L_m, bronchoconstriction index -BCI), temporal evolution of subjects' masses, and percent composition of the FOCC.

RESULTS

Regarding the body mass of the animals, the results demonstrated an average body mass gain of 10.5 g for the animals in the AA + T group, and 15.5 g for those in the AA + O group. On the other hand, the body mass of animals in the SHS + T and SHS + O suffered an average loss of 14.4 and 4.75 g, respectively. Regarding respiratory system analyzes, our results demonstrated significant changes in all respiratory mechanics variables and lung parenchyma morphometry analyzed for the SHS + T group when compared to the AA + T group (p < 0,05), confirming the establishment of pulmonary injury induced by SHS exposure. We also observed that rats pretreated orally with FOCC (SHS + O) showed improvement in all variables when compared to the SHS + T group (p < 0,05), thus demonstrating the effectiveness of FOCC in preventing lung damage induced by short-term SHS exposure.

CONCLUSION

In conclusion, our results demonstrate that FOCC was able to prevent lung injury in rats submitted to short-term SHS exposure.

Associations between sleep bruxism, sleep quality, and exposure to secondhand smoke in Japanese young adults: a cross-sectional study

OBJECTIVE

Sleep bruxism, a major sleep disorder that causes serious harm to oral health, is considered a multifactorial disease. Sleep bruxism can be induced by smoking, which also adversely affects sleep quality. The objective of present study was to clarify the associations between sleep bruxism, sleep quality, and exposure to secondhand smoke (SHS).

METHODS

To assess the prevalence of sleep bruxism, sleep quality, and SHS exposure, we conducted oral examinations and self-report questionnaires on university students in Japan. Sleep bruxism and quality were screened using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) and the third edition of the International Classification of Sleep Disorders (ICSD-3). The inclusion criteria were adults aged between 18 and 19 years, non-smokers and non-alcohol drinkers. The exclusion criteria was failing to complete the questionnaire in full.

RESULTS

We analyzed a total of 1781 Japanese young adults. Young adult females who had been exposed to SHS had worse sleep quality (p = 0.019) than those who had not. Young adult female with worse sleep quality showed a higher prevalence of sleep bruxism (p = 0.034) than those with better sleep quality. Using structural equation modeling, direct associations were identified between SHS exposure and poor sleep quality (standardized coefficients, 0.153; p = 0.008) and between sleep bruxism and poor sleep quality (standardized coefficients, 0.187; p = 0.022) in young adult females. However, no association was found among young adult males.

CONCLUSION

SHS exposure is indirectly associated with sleep bruxism through poor sleep quality in Japanese young adult females.

Auriculotherapy for sleep quality in people with primary insomnia: A protocol for a systematic review and meta-analysis

BACKGROUND

Primary insomnia is one of the common sleep disorders. Auriculotherapy originated from traditional Chinese medicine, has been thought as a promising treatment for primary insomnia. We aim to evaluate the efficacy and safety of auriculotherapy for patients with primary insomnia through this systematic review.

METHODS

Five English databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, and CINAHL), 4 Chinese databases (CBM, CNKI, CQVIP, and Wanfang), and 5 clinical trial registration databases (ClinicalTrials.gov, ANZCTR, EU-CTR, ChiCTR, and ICTRP) will be searched from establishment of the database until November 2018. Articles written in English or Chinese languages will be included. The randomized controlled trials of auriculotherapy (auricular acupuncture and auricular acupressure) for patients with primary insomnia will be included. The primary outcome will be assessed according to the Pittsburgh sleep quality index. Meta-analysis will be conducted with the use of RevMan 5.3. The specific process will refer to the Cochrane Handbook 5.1 for Systematic Review.

RESULTS

High-quality synthesis of current evidence on the efficacy and safety of auriculotherapy for primary insomnia will be provided in this study.

CONCLUSION

This systematic review aims to present evidence for whether auriculotherapy is an effective intervention which can improve sleep quality in patients suffering primary insomnia.

PROSPERO REGISTRATION NUMBER

CRD42019106422.