Sleep, Shocks and SNUS: A Case Report on Nicotine-Induced Hypnic Jerks.

Abstract

SNUS is a smokeless tobacco that is placed under the (upper) lip, Although the adverse effects of nicotine have been extensively described, its impact on sleep remains relatively unknown. We describe a case of hypnic jerks caused by SNUS. Hypnic jerks are short, sudden, and spontaneous muscle contractions occurring at sleep onset that may increase due to stimulants, such as SNUS. We describe a 32-year-old male patient with disturbed sleep for 5 years. The patient experienced shock-like episodes when falling asleep since he had been using SNUS. A polysomnography demonstrated an increase in muscle activity on the EMG- and the leg channel during transition from light sleep to wake, as well as an increase in heart rate. A diagnosis of hypnic jerks was made. The patient was advised to quit using SNUS. After discontinuing SNUS use, the patient fully recovered. This case report is the first to describe hypnic jerks caused by SNUS. The hypnic jerks were confirmed by polysomnography. It is also the first to describe the negative effects of SNUS on sleep. Meticulous history taking, addressing the patient's drug use, including stimulants such as SNUS/nicotine, may help prevent unnecessary testing.