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Use of varenicline in smokeless tobacco cessation influences sleep quality and dream recall frequency but not dream affect.

Francesca Polini, Rosastella Principe, Serena Scarpelli, Francesca Clementi, Luigi De Gennaro

Sleep Medicine February 2017 DOI: 10.1016/j.sleep.2016.11.002 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 38
Population Smokers participating in smoking-cessation programs
Interventions Varenicline Nicotine replacement therapy
Duration One-week sleep diary at baseline and two weeks after beginning treatment
Measures sleep diary, dream recall (DR)
Topics Dreaming
Keywords Acetylcholine Dream Intrasleep awakenings Smoking cessation Varenicline
Key findings The VCL group showed a significant increase in night-time awakenings and dream recall from baseline to two weeks of treatment. Dream recall correlated with sleep fragmentation only during VCL treatment, leading the authors to argue that varenicline cannot be considered a direct cause of abnormal dreams and that frequent dream recall may reflect lighter sleep, consistent with 'activation models'.

Abstract

Varenicline (VCL) treatment has become popular as a part of smoking-cessation therapies, even though its possible implications in neuropsychiatric adverse events include abnormal sleep and nightmares. Our study is the first aimed at prospectively investigating changes in sleep and dream measures across such treatment by using a one week sleep diary and collecting dream recall (DR). Thirty-eight smokers participated in two different effective smoking-cessation programs: 25 subjects received VCL, 13 subjects received nicotine replacement therapy (NRT). Participants were requested to fill out a sleep diary and audio-record dreams for one week, both at baseline assessment (T0) and after two weeks from the beginning of treatment (T1). Differences in sleep and dream measures were tested using mixed Analysis of Covariance with time (T0 vs T1) as a within-subject factor and group (VCL vs NRT) as a between-subject factor, considering age as a covariant. Sleep measures showed a significant increase in the number of awakenings in the VCL group at T1 compared to T0. The VCL group reported an increase in DR rate at T1. These sleep and dream measures were intercorrelated, but only at T1 and during VCL treatment. The correlations between DR rate and sleep fragmentation measures underlined that VCL cannot be considered as a direct cause of abnormal dreams. Comparisons between groups cast some doubts on the actual existence of abnormal dreams, at least as compared to the NRT group. Our results are consistent with the 'activation models', showing that numerous DRs in the VCL group may be related to lighter sleep.

Comparable studies

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Study Year Design Participants
Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Student volunteers trained to become lucid and signal lucidity with horizontal eye... 2009 Observational study n = 6
Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Young adults with a mean age of 20 years 2002 Prospective observational study n = 116
Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... 1987 Case-control study n = 11
The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams 2004 Observational cohort n = 147
Dreaming in NREM Sleep: A High-Density EEG Study of Slow Waves and Spindles Healthy human subjects 2018 Observational cohort n = 14

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