An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Choice A reason: While some smokers may experience initial sedation due to nicotine’s biphasic effects, the stimulant properties and withdrawal during sleep typically prevent sustained deep sleep. This pattern is not consistently supported by sleep studies. Choice B reason: Nicotine acts as a central nervous system stimulant, increasing arousal and reducing sleep depth. Smokers often report difficulty initiating sleep and experience fragmented sleep due to withdrawal symptoms during the night. Choice C reason: Smoking does not decrease the physiological need for REM sleep. Instead, it disrupts sleep architecture, including reduced REM and slow-wave sleep, but the body still requires these stages for restoration. Choice D reason: Although smoking can increase sleep latency and reduce total sleep time, this choice is less comprehensive than B, which captures both initiation and maintenance disturbances.