It's not unusual for college students to consider caffeine a separate food group. Between living with a dorm full of our best friends, the constant mental stimulation offered by 24-hour cable TV and high-speed Internet, and poor time management skills that lead to desperate all-nighters, it's probably surprising that we get as much sleep as we do. So we venerate caffeine. As I'm writing this column I have a 20-ounce Diet Coke next to me, not to mention the 12-ounce Cherry Coke already in me. And I'm not even close to the biggest caffeine fiend I know.
Sleep deprivation is ubiquitous, both in college and throughout the country. A recently released Centers for Disease Control and Prevention study showed that 21.9 percent of 18- to 34-year-old survey respondents said over the past 30 days, they had not once gotten enough sleep. This doesn't include respondents who sometimes or frequently don't get enough sleep. When combined with results showing that increasing education levels means increasing sleep deprivation, the young college-educated adult can't win.
No one really knows why we need sleep. Certain parts of the brain and metabolism are actually more active during sleep, so we know something important is going on. And we know sleep deprivation doesn't just cause tiredness the next day. It causes you to be more sensitive to pain, it deranges your immune system, it makes you overreact to unpleasant emotions -- a miserable experience most people have endured more than once. Then there's the bad news -- study after study shows that sleep deprivation contributes to depression, weight gain, poor job performance and, yes, premature death. Despite the dire warnings you frequently see on morning news shows, we continue to deprive ourselves of sleep. Stubborn continued sleep deprivation in the face of countless studies brings us back to caffeine use -- and caffeine abuse.
In the Diagnostic and Statistical Manual of Mental Disorders (the bible of mental illness), there's a chapter devoted to caffeine-related disorders tucked right between amphetamines and cannabis (in all fairness, this is alphabetical order, not in order of importance or severity). The diagnostic criteria for caffeine intoxication are: a) recent caffeine ingestion, b) five or more of the following symptoms: restlessness, nervousness, excitement, insomnia, flushed face, diuresis (frequent urination), gastrointestinal disturbance, muscle twitching, rambling thought or speech, elevated heart rate, inexhaustibility, psychomotor agitation.
Now think back to the last time you had two or more caffeinated beverages in a short period of time. Did your hands tremble? Did your heart race? Was it hard to sit still? Were you peeing every 10 minutes? Was it hard to get to sleep later that day? Then you were intoxicated on caffeine. In addition to caffeine intoxication, there's also caffeine-induced anxiety disorder (prominent anxiety, panic attacks, obsessions or compulsions), caffeine-induced sleep disorder (either insomnia at night or hypersomnia during the day) and caffeine withdrawal (headache, marked fatigue, drowsiness, anxiety, depression, nausea or vomiting). For added misery, caffeine withdrawal symptoms can last for up to a week.
The interaction between caffeine and sleep deprivation is a two-way street. Caffeine masks sleep deprivation symptoms, but caffeine can also cause sleep deprivation. Like any drug, caffeine affects different people different ways. People metabolize caffeine at greatly differing rates, which is why some people need their second cup of coffee two hours after the first, and some people can't sleep that night if they have caffeine after noon. Some are more likely to become hooked; research has found a gene that may be linked to people's susceptibility to caffeine dependence.
Ever since it was removed from the list of banned drugs, endurance athletes have used caffeine to boost their performance. (Studies suggest, however, that this may lead to more pain and muscle damage after the fact.) None of this is to suggest that caffeine is bad for you. It has legitimate medical uses in migraine treatment and in premature infants with difficulty breathing, but should be used in moderation.
Anna is a University Medical student. She can be reached at asedney@cavalierdaily.com.
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