Association of Cigarette Smoking with Sleep Disturbance and Neurotransmitters in Cerebrospinal Fluid

Abstract

Background

Cigarette smoking has shown to be associated with sleep disturbance, especially prolonged sleep onset latency (SOL). Cigarette smoking stimulates the release of dopamine (DA) and serotonin (5-HT), which might promote awakening and inhibit rapid eye movement sleep. Dopamine transporter (DAT) and serotonin transporter play a key role in the reuptake of DA and 5-HT from the synaptic cleft into presynaptic neurons. However, the relationship among cigarette smoking, sleep disturbance and neurotransmitters has never been investigated in human cerebrospinal fluid (CSF).

Methods

A total of 159 Chinese male subjects (81 active smokers and 78 non-smokers) who would undergo lumbar puncture before the surgery of anterior cruciate ligament reconstruction were recruited and 5mL-CSF samples were collected incidentally. CSF levels of DA, DAT, 5-HT, and serotonin transporter were measured using radioimmunoassay and ELISA. Sociodemographic data and the Pittsburgh Sleep Quality Index (PSQI) scale were collected before surgery.

Results

PSQI global scores, SOL, and CSF DA levels were significantly higher in active smokers compared to non-smokers (2.00 [1.00–4.75] scores vs 4.00 [3.00–6.00] scores, p = 0.001; 10.00 [5.00–15.00] minutes vs 15.00 [10.00–30.00] minutes, p = 0.002; 87.20 [82.31–96.06]ng/mL vs 107.45 [92.78–114.38] ng/mL, p < 0.001), while CSF DAT levels were significantly lower in active smokers (0.35 [0.31–0.39] ng/mL vs 0.29 [0.26–0.34] ng/mL, p < 0.001).

Conclusion

Cigarette smoking was indeed associated with sleep disturbance, shown by prolonged SOL, higher DA levels and lower DAT levels in CSF of active smokers.

Keywords:

• sleep
• cigarette smoking
• dopamine
• cerebrospinal fluid

Abbreviations

SOL, sleep onset latency; DA, dopamine; 5-HT, serotonin; REM, rapid eye movement; NREM, non-rapid eye movement; DAT, dopamine transporter; SERT, serotonin transporter; CSF, cerebral spinal fluid; PSQI, Pittsburgh Sleep Quality Index; SAS, Self-Rating Anxiety Scale; BDI, Beck Depression Inventory; ANOVA, one-way analysis of variance; ANCOVA, analysis of covariance; HDL, high-density lipoprotein; LDL, low-density lipoprotein; ALT, alanine aminotransferase; CHO, total cholesterol; TG, triglyceride; GGT, gamma-glutamyl transferase; AST, aspartate aminotransferase.

Acknowledgments

The authors thank all of the participants for their willingness to participate in the study and the time that they devoted to the study. The authors thank Drs Srinivasan Nithiyanantham and Hui-Chih Chang for English language polishing.

Disclosure

The authors report no conflicts of interest for this work.

Additional information

Funding

This work was supported by the following grants: The Technology Support Project of Xinjiang (2017E0267), Natural Science Foundation of Xinjiang Province (2018D01C228 and 2018D01C239), Tianshan Youth Project-Outstanding Youth Science and Technology Talents of Xinjiang (2017Q007), Natural Science Foundation of China (81421004), the 10th Inner Mongolia Grassland Talents Project, Beijing Natural Science Foundation (7152074), and The Opening Project of Zhejiang Provincial Top Key Discipline of Pharmaceutical Sciences.