Can caffeine help the sleep deprived feel better?

I am proud to say that I have never once pulled an "all nighter" to study for a test. Sure, I stayed awake many nights in the hospital doing grueling hours during my medical training, but I never willingly turned down a good night's sleep. Many of my friends and colleagues, though, fueled their all night studying with caffeine. Was it a good idea?

Caffeine is the most widely used psychoactive drug in the world. Up to 90% of Americans take it regularly, usually in the form of coffee, tea, or soft drinks, sometimes in a tablet (No-Doz and others). The average daily dose, 300mg, is the equivalent of three cups of coffee. No wonder selling expensive caffeinated drinks is good business!

The best way to determine the risks and benefits of a drug is to give the drug or a placebo to matched groups of people who have never been exposed tothe drug before. But it's hard to find people who don't use caffeine, and the small minority who don't may abstain because they are physiologically different from others, finding caffeine unpleasant rather than pleasurable. Another problem is that most controlled studies don't last long enough to reveal th eeffects of chronic use. Researchers are more interested in habitual users.

One of the most important questions raised by research is whether caffeine offers a true benefit (improved alertness and sustained attention, for example) or merely wards off the symptoms of caffeine withdrawal. Basic pharmacology is one guide here. Eat or drink substances containing caffeine and it will bequickly and completely absorbed. Blood levels peak in well under an hour, and 50% of ingested caffeine leaves the body within four to six hours.

Withdrawal symptoms generally begin 12 to 24 hours after stopping use butcan appear within 6 hours. So it's not unusual to notice the symptoms in the morning after drinking coffee the previous day. On average, withdrawal symptoms last one or two days, but they can continue for as long as two weeks.

Headache is the most common withdrawal symptom, experienced by up to 50% of caffeine users. Other symptoms are fatigue, low energy, decreased alertness,and depressed or irritable mood. Intellectual performance, vigilance, and psychomotor speed decline. About 1 in 10 withdrawing caffeine users suffers significant distress or impairment.

Studies confirm that these symptoms have a pharmacological basis; they aren't just a result of people's expectations. The more caffeine you ingest,the more uncomfortable the withdrawal symptoms. Have a drink of coffee or tea, and the symptoms will go away within an hour.

The daily cycle of withdrawal and relief is so common that many experts question whether caffeine's stimulant properties yield any net benefit at all. Tolerance to the stimulant effect develops rapidly. Non-consumers (or consumerswho have abstained for a week) say they feel more alert after consuming caffeine, but objective tests show no improvement in their performance. And non-consumers start out more alert and at ease than habitual consumers after anight of abstinence. Bumping up the dose usually doesn't yield extra benefit but only causes jitters or tension that may degrade performance.

Using caffeine to stay awake when you are not getting enough sleep is a poor idea. There is no evidence that caffeine reverses the effects of sleep deprivation. It's not a reliable aid for students burning the midnight oil. Andabsolutely don't trust it to keep you out of trouble behind the wheel of a car. The best treatment for sleep deprivation is sleep.

One study comparing subjects both in and out of withdrawal, sleep-deprived and not, found that caffeine did not improve performance for any of them. Apparently improved alertness and mood after ingesting caffeine results mostly from the relief of withdrawal symptoms.

So we probably have to acknowledge that caffeine doesn't deliver, and insome ways for example, by disrupting sleep - can make life more difficult. So enjoy your daily coffee, tea or cola, but don't count on caffeine to move you closer to your goals. And keep in mind that the need to avoid withdrawal symptoms may play a big role in your habit and even your preference for certain products over others.

Do you use caffeine to help keep you awake late into the night? How does it make you feel in the days after?

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