Caffeine that is consumed in the United States is in the form of coffee, and many adults drink coffee on a daily basis. Turns out that a lot of healthy subjects will use coffee as a means of cognitive enhancement (i.e. help with concentration and memory) (Franke et al., 2014). Since coffee does affect our wakeful state, how does it affect us when we are in poor sleep quality?
A study examined the effects of coffee based on vigilance on a group of participants with differing sleep quality based on a sleep questionnaire. (Anderson et al., 2018) The participants were randomized into two groups in which they would either drink coffee or water. A continuous performance test which assessed vigilance was administrated at minutes 30, 90, and 120 (representing the rise of caffeine levels, the peak, and the falling levels) (Anderson et al., 2018). The results showed that coffee was able to improve and stabilize reaction time at all of the assessment times, regardless of the participants recent sleep history. Although there was a reduction in omission errors (false negatives), commission error (false positives) increase was noted at 90 minutes (Anderson et al., 2018).
This study illustrates that we can stay just as vigilant on coffee with less sleep, but our accuracy is compromised in the process. A past study showed that sleep deprivation can inappropriately modulate the emotional side of the brain to negative aversive stimuli (i.e. you are very reactive to the smallest things) (Yoo et al., 2007). Another study showed that participants who were sleep deprived and ingested 200 mg of caffeine twice a day showed overconfidence despite poor performance in the vigilance test (Kilpeläinen et al., 2010). Collectively, all these studies show that coffee/caffeine can help with sleep deprivation and the deficits that it carries, but it is not sustainable.
Being in the health care field is very demanding and requires us to sincerely take care of ourselves to provide the proper care that each patient deserves. Although getting sleep may not be priority to us when we have multiple tasks to juggle, for our sakes (and the sake of others) we need to be able to get the proper amount of sleep so that we are accurate, just as vigilant, and pleasant towards others. Just as many themes in medicine, drinking coffee in moderation with proper sleep will likely give us the most benefits. Let’s not forget to take care of ourselves as we move forward!
References:
Anderson JR, Hagerdorn PL, Gunstad J, Spitznagel MB. Using coffee to compensate for poor sleep: Impact on vigilance and implications for workplace performance. Appl Ergon. 2018 Jul;70:142-147.
Franke AG, Bagusat C, Rust S, Engel A, & Lieb K (2014). Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects. European Archives of Psychiatry and Clinical Neuroscience, 264(S1), 83-90.
Kilpeläinen AA, Huttunen KH, Lohi JJ. Effect of caffeine on vigilance and cognitive performance during extended wakefulness. Int. J. Aviat. Psychol., 20 (2) (2010), pp. 144-159.
Yoo SS, Gujar N, Hu P, Jolesz FA, Walker MP. The human emotional brain without sleep--a prefrontal amygdala disconnect. Curr Biol. 2007 Oct 23;17(20):R877-8.
This topic, especially your last paragraph, immediately made me think of burnout and how this year it is at an all-time high in healthcare professionals, especially with COVID-19. I feel like there is a level of dependence on coffee to wake us up and get us through the day, but I'm not sure if it should be at the cost of our patients.
ReplyDeleteIn one study, they found that over half of all physicians in the US experience burnout symptoms and that burnout is correlated with major medical errors (Reith, 2018). This same study also talks about other ways to prevent burnout like achieving better work-life balance and better peer support. Maybe those two in combination with coffee to boost the start to your day could result in less burnout, more alertness, and better patient care.
Reith T. P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Cureus, 10(12), e3681. https://doi.org/10.7759/cureus.3681
As a huge supporter of coffee, I thought it was interesting how you were able to tie in benefits as well as risk factors to pay attention to. I can definitely understand how coffee as a replacement for sleep is not ideal, but it's interesting that coffee actually ameliorates some of the issues associated with sleep deprivation. I found another paper that highlights how some of the other components of coffee aside from caffeine help to alleviate other physiological symptoms such as helping in Parkinson's, Alzheimer's, cancer, and diabetes mellitus. The researchers also found that coffee is able to reduce oxidative stress by activating mRNA and protein expression pathways (Butt & Sultan, 2011).
ReplyDeleteButt, M.S., Sultan, M.T. (2011). Coffee and its consumption: benefits and risks. Critical Review Food Science and Nutrition, 51(4), 363-373. https://doi.org/10.1080/10408390903586421