The association between e-cigarette use and sleep health: A systematic review and meta-analysis.

INTRODUCTION: E-cigarette use has raised concerns about health impacts beyond nicotine dependence, yet evidence on the relationship between vaping and sleep disturbance remains limited. This systematic review and meta-analysis examined the association between exclusive e-cigarette use and sleep health. METHODS: MEDLINE, Embase and PsycINFO were searched up to July 2025 for English-language, peer reviewed human studies. Eligible studies were peer-reviewed observational studies of people who used nicotine e-cigarettes without combustible cigarette use, compared with non-users, that reported sleep health outcomes such as sleep duration and quality. Two independent reviewers screened all records, extracted data using the STROBE checklist, and assessed quality with the Joanna Briggs Institute Critical Appraisal tool. Effect sizes were pooled using random-effects models, and odds ratios (ORs) and 95% confidence intervals (CIs) are reported. RESULTS: Sixteen cross-sectional studies met inclusion criteria, of which twelve were included in the meta-analysis, most of moderate quality. Past 30-day exclusive e-cigarette users had a 38% greater likelihood of poor sleep health than never users (OR=1.38; 95% CI: 1.24-1.55), with similar associations in adolescents (OR=1.32; 95% CI: 1.06-1.66) and adults (OR=1.36; 95% CI: 1.15-1.61). CONCLUSIONS: E-cigarette use was associated with poorer sleep health, with similar associations in adolescents and adults. Given rising youth vaping, longitudinal studies with objective measures are needed to inform public health strategies.