Die Auswirkungen von Nikotin und eines Nikotinentzugs auf polysomnografische und neuroendokrine Parameter

Die Auswirkungen von Nikotin und eines Nikotinentzugs auf polysomnografische und neuroendokrine Parameter

Eine systematische Übersichtsarbeit

The effects of nicotine and its withdrawal on sleep and neuroendocrine parameters

Clara Landgraf

Doctoral thesis

Date of Examination: 2013-05-14

Date of issue: 2013-05-10

Advisor: Rodenbeck, Andrea Prof. Dr.

Referee: Raupach, Tobias PD Dr.

Referee: Straube, Sebastian PD Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0018-00A8-C

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Abstract

English

Nicotine and its withdrawal influence objective markers of sleep and neuroendocrine parameters. This systematic review compares current studies, investigating the effects of nicotine and its withdrawal on sleep, measured by polysomnography or actigraphy and cortisol and dopamine levels. In animal studies, nicotine had a dose-dependent effect on sleep, namely lower doses reduced REM-sleep and higher doses promoted wakefulness. Nonsmokers showed a reduction of REM-sleep after nicotine administration, while in depressed nonsmokers an improvement in sleep quality and depression was observed. The first days of withdrawal in smokers caused an increased fragmentation of sleep, which could be reduced by using nicotine replacement therapy. The only publication which studied the withdrawal a longer time, showed an increase of REM-sleep and a decrease of total sleep time. The parameters of the dopaminergic system were stable during the first hours of abstinence, but in a long-term study an increase in dopamine receptors was observed. Nicotine also led to an increased secretion of hormones of the HPA axis. During nicotine withdrawal, decreased concentrations of cortisol were measured. A lower cortisol concentration during abstinence predicted higher severty of withdrawal symptoms and may be a predictor of relapse.

Keywords: Nicotine; Sleep; Cortisol; Dopamine; Withdrawal