Moderating Effects of Smoking Status on the Relationships Between Mental Health Problems and Poor Sleep

A dearth of research exists on the effects of smoking on the relationship between sleep and mental illnesses. To examine the association of mental health problems with days of poor sleep based on whether participants smoked. A secondary analysis of the 2015 Behavioral Risk Factor Surveillance System (N=16,253) was conducted using linear regressions models. The study found that the associations between mental health and sleep quality, measured as days of poor sleep, varied by the respondents' smoker status among those who reported having less than 20 days of mental health problems. The difference in days of poor sleep between smokers and non-smokers were greatest among those who experienced 10 to 19 days of mental health problems. Of those with 10 to 19 days of mental health problems in the past 30 days, an average of 8.5 days of poor sleep was estimated among smokers, which was 3 more days than that of non-smokers (p=.001). The differences in days of poor sleep were not significantly different between smokers and non-smokers among those who reported 20 or more days of mental health problems. Days of mental health problems were directly related to days of poor sleep. This relationship was moderated by smoking status. Special attention needs to be paid to those who have comparably moderate levels of mental illnesses because non-smoking status can significantly improve sleep quality. Further research is needed to confirm the impact of smoking on the associations of mental illnesses with poor sleep.