Smoking and sleep disorders in Chinese adolescents.
OBJECTIVE
To investigate the association between adolescent smoking and sleep disorders.


METHODS
In the Hong Kong student obesity surveillance project, 29,397 Chinese students, aged 12-18 years, completed a health survey. Insomnia was defined as having any of the following three symptoms: difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early morning awakening (EMA). The presence of snoring and difficulty breathing during sleep (DBS) was also reported. Logistic regression yielded adjusted odds ratios (ORs) for each sleep disorder by smoking status.


RESULTS
Compared with never smokers, the ORs (95% CI) of insomnia were 1.39 (1.25-1.54) for experimenters (smoked once or a few times) and 0.91 (0.83-1.00) for current smokers. The corresponding ORs were 1.42 (1.16-1.74) and 3.58 (3.15-4.06) for snoring (P for trend<0.001) and 1.40 (1.10-1.79) and 3.39 (2.97-4.03) for DBS (P for trend<0.001). Current smokers compared with never smokers were less likely to report DIS (OR=0.43, 95% CI=0.38-0.50, P<0.001) and EMA (OR=0.83, 95% CI=0.73-0.94, P=0.003), but more likely to report DMS (OR=1.45, 95% CI=1.28-1.63, P<0.001).


CONCLUSIONS
In terms of dosage, adolescent smoking was associated with snoring and DBS, with increasing ORs from never smokers to experimental and current smokers. Current smoking was associated positively with DMS, but negatively with DIS and EMA.
Mak
Kwok-Kei
KK
School of Public Health, The University of Hong Kong, Hong Kong.
Ho
Sai-Yin
SY
Thomas
G Neil
GN
Lo
Wing-Sze
WS
Cheuk
Daniel Ka-Leung
DK
Lai
Yuen-Kwan
YK
Lam
Tai-Hing
TH
D000293:Adolescent; D002648:Child; D005260:Female; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*; D012913:Snoring / Q000453:epidemiology / Q000209:etiology