Abstract
BACKGROUND: The increasing popularity of electronic cigarettes (e-cigarettes) has introduced new public health challenges and concerns. While promoted as safer alternatives to conventional tobacco and as tools for quitting smoking, e-cigarettes have raised alarm about possible long-term health consequences. This systematic review and meta-analysis sought to evaluate the association between electronic cigarette consumption and sleep disturbances. METHODS: We performed comprehensive searches in EMBASE, Web of Science, and PubMed up to September 18, 2024, to locate studies examining the link between e-cigarette use and sleep duration, sleep disorders, and insomnia. A meta-analysis was conducted to calculate pooled odds ratios (ORs). The quality of the studies was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed using R software (Version 4.3). RESULTS: A total of 14 cross-sectional studies were included from 554 unique records screened. E-cigarette users exhibited a notably elevated risk of having shorter sleep duration compared to non-users, with a pooled odds ratio of 1.38 (95% CI: 1.24-1.55). Several studies reported that e-cigarette users also had higher odds of sleep disturbances, such as insomnia and reliance on sleep medications. Among adolescents, e-cigarette use was associated with a 33 to 61% increased risk of inadequate sleep. CONCLUSION: E-cigarette use may be associated with sleep disturbances, including shorter sleep duration and increased sleep difficulties. Future long term longitudinal studies are warranted for better evidence.