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Lin YS, Lange D, Baur DM, Foerges A, Chu C, Li C, Elmenhorst EM, Neumaier B, Bauer A, Aeschbach D, Landolt HP, Elmenhorst D. Repeated caffeine intake suppresses cerebral grey matter responses to chronic sleep restriction in an A 1 adenosine receptor-dependent manner: a double-blind randomized controlled study with PET-MRI. Sci Rep 2024; 14:12724. [PMID: 38830861 PMCID: PMC11148136 DOI: 10.1038/s41598-024-61421-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Evidence has shown that both sleep loss and daily caffeine intake can induce changes in grey matter (GM). Caffeine is frequently used to combat sleepiness and impaired performance caused by insufficient sleep. It is unclear (1) whether daily use of caffeine could prevent or exacerbate the GM alterations induced by 5-day sleep restriction (i.e. chronic sleep restriction, CSR), and (2) whether the potential impact on GM plasticity depends on individual differences in the availability of adenosine receptors, which are involved in mediating effects of caffeine on sleep and waking function. Thirty-six healthy adults participated in this double-blind, randomized, controlled study (age = 28.9 ± 5.2 y/; F:M = 15:21; habitual level of caffeine intake < 450 mg; 29 homozygous C/C allele carriers of rs5751876 of ADORA2A, an A2A adenosine receptor gene variant). Each participant underwent a 9-day laboratory visit consisting of one adaptation day, 2 baseline days (BL), 5-day sleep restriction (5 h time-in-bed), and a recovery day (REC) after an 8-h sleep opportunity. Nineteen participants received 300 mg caffeine in coffee through the 5 days of CSR (CAFF group), while 17 matched participants received decaffeinated coffee (DECAF group). We examined GM changes on the 2nd BL Day, 5th CSR Day, and REC Day using magnetic resonance imaging and voxel-based morphometry. Moreover, we used positron emission tomography with [18F]-CPFPX to quantify the baseline availability of A1 adenosine receptors (A1R) and its relation to the GM plasticity. The results from the voxel-wise multimodal whole-brain analysis on the Jacobian-modulated T1-weighted images controlled for variances of cerebral blood flow indicated a significant interaction effect between caffeine and CSR in four brain regions: (a) right temporal-occipital region, (b) right dorsomedial prefrontal cortex (DmPFC), (c) left dorsolateral prefrontal cortex (DLPFC), and (d) right thalamus. The post-hoc analyses on the signal intensity of these GM clusters indicated that, compared to BL, GM on the CSR day was increased in the DECAF group in all clusters but decreased in the thalamus, DmPFC, and DLPFC in the CAFF group. Furthermore, lower baseline subcortical A1R availability predicted a larger GM reduction in the CAFF group after CSR of all brain regions except for the thalamus. In conclusion, our data suggest an adaptive GM upregulation after 5-day CSR, while concomitant use of caffeine instead leads to a GM reduction. The lack of consistent association with individual A1R availability may suggest that CSR and caffeine affect thalamic GM plasticity predominantly by a different mechanism. Future studies on the role of adenosine A2A receptors in CSR-induced GM plasticity are warranted.
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Affiliation(s)
- Yu-Shiuan Lin
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm Kleinstr. 27, 4002, Basel, Switzerland.
- Research Cluster Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
- Athinoula. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachussetts General Hospital, Harvard Medical School, Boston, USA.
| | - Denise Lange
- Department of Sleep and Human Factors, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Diego Manuel Baur
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Anna Foerges
- Institute of Neuroscience and Medicine, INM-2, Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, North Rhine-Westphalia, Germany
- Department of Neurophysiology, Institute of Zoology (Bio-II), RWTH Aachen University, Aachen, Germany
| | - Congying Chu
- Institute of Neuroscience and Medicine, INM-2, Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, North Rhine-Westphalia, Germany
| | - Changhong Li
- Institute of Neuroscience and Medicine, INM-2, Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, North Rhine-Westphalia, Germany
| | - Eva-Maria Elmenhorst
- Department of Sleep and Human Factors, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Institute for Occupational, Social, and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Bernd Neumaier
- Institute of Neuroscience and Medicine, INM-5, Forschungszentrum Jülich, Jülich, Germany
| | - Andreas Bauer
- Institute of Neuroscience and Medicine, INM-2, Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, North Rhine-Westphalia, Germany
| | - Daniel Aeschbach
- Department of Sleep and Human Factors, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Institute of Experimental Epileptology and Cognition Research, University of Bonn Medical Center, Bonn, Germany
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - David Elmenhorst
- Institute of Neuroscience and Medicine, INM-2, Forschungszentrum Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, North Rhine-Westphalia, Germany.
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.
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Subramaniyan M, Wang C, Laxminarayan S, Vital-Lopez FG, Hughes JD, Doty TJ, Reifman J. Electroencephalographic markers from routine sleep discriminate individuals who are vulnerable or resilient to sleep loss. J Sleep Res 2024; 33:e14060. [PMID: 37800178 DOI: 10.1111/jsr.14060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
Sleep loss impairs cognition; however, individuals differ in their response to sleep loss. Current methods to identify an individual's vulnerability to sleep loss involve time-consuming sleep-loss challenges and neurobehavioural tests. Here, we sought to identify electroencephalographic markers of sleep-loss vulnerability obtained from routine night sleep. We retrospectively analysed four studies in which 50 healthy young adults (21 women) completed a laboratory baseline-sleep phase followed by a sleep-loss challenge. After classifying subjects as resilient or vulnerable to sleep loss, we extracted three electroencephalographic features from four channels during the baseline nights, evaluated the discriminatory power of these features using the first two studies (discovery), and assessed reproducibility of the results using the remaining two studies (reproducibility). In the discovery analysis, we found that, compared to resilient subjects, vulnerable subjects exhibited: (1) higher slow-wave activity power in channel O1 (p < 0.0042, corrected for multiple comparisons) and in channels O2 and C3 (p < 0.05, uncorrected); (2) higher slow-wave activity rise rate in channels O1 and O2 (p < 0.05, uncorrected); and (3) lower sleep spindle frequency in channels C3 and C4 (p < 0.05, uncorrected). Our reproducibility analysis confirmed the discovery results on slow-wave activity power and slow-wave activity rise rate, and for these two electroencephalographic features we observed consistent group-difference trends across all four channels in both analyses. The higher slow-wave activity power and slow-wave activity rise rate in vulnerable individuals suggest that they have a persistently higher sleep pressure under normal rested conditions.
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Affiliation(s)
- Manivannan Subramaniyan
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Chao Wang
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Srinivas Laxminarayan
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Francisco G Vital-Lopez
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - John D Hughes
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Tracy J Doty
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, Maryland, USA
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Subramaniyan M, Hughes JD, Doty TJ, Killgore WDS, Reifman J. Individualised prediction of resilience and vulnerability to sleep loss using EEG features. J Sleep Res 2024:e14220. [PMID: 38634269 DOI: 10.1111/jsr.14220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
It is well established that individuals differ in their response to sleep loss. However, existing methods to predict an individual's sleep-loss phenotype are not scalable or involve effort-dependent neurobehavioural tests. To overcome these limitations, we sought to predict an individual's level of resilience or vulnerability to sleep loss using electroencephalographic (EEG) features obtained from routine night sleep. To this end, we retrospectively analysed five studies in which 96 healthy young adults (41 women) completed a laboratory baseline-sleep phase followed by a sleep-loss challenge. After classifying subjects into sleep-loss phenotypic groups, we extracted two EEG features from the first sleep cycle (median duration: 1.6 h), slow-wave activity (SWA) power and SWA rise rate, from four channels during the baseline nights. Using these data, we developed two sets of logistic regression classifiers (resilient versus not-resilient and vulnerable versus not-vulnerable) to predict the probability of sleep-loss resilience or vulnerability, respectively, and evaluated model performance using test datasets not used in model development. Consistently, the most predictive features came from the left cerebral hemisphere. For the resilient versus not-resilient classifiers, we obtained an average testing performance of 0.68 for the area under the receiver operating characteristic curve, 0.72 for accuracy, 0.50 for sensitivity, 0.84 for specificity, 0.61 for positive predictive value, and 3.59 for likelihood ratio. We obtained similar performance for the vulnerable versus not-vulnerable classifiers. These results indicate that logistic regression classifiers based on SWA power and SWA rise rate from routine night sleep can largely predict an individual's sleep-loss phenotype.
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Affiliation(s)
- Manivannan Subramaniyan
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Development Command, Fort Detrick, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - John D Hughes
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Tracy J Doty
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - William D S Killgore
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Development Command, Fort Detrick, Maryland, USA
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Nakie G, Takelle GM, Rtbey G, Andualem F, Tinsae T, Kassa MA, Tadesse G, Fentahun S, Wassie YA, Segon T, Kibralew G, Melkam M. Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study. Front Psychiatry 2024; 15:1370757. [PMID: 38559402 PMCID: PMC10979362 DOI: 10.3389/fpsyt.2024.1370757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.
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Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Quiquempoix M, Drogou C, Erblang M, Van Beers P, Guillard M, Tardo-Dino PE, Rabat A, Léger D, Chennaoui M, Gomez-Merino D, Sauvet F. Relationship between Habitual Caffeine Consumption, Attentional Performance, and Individual Alpha Frequency during Total Sleep Deprivation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4971. [PMID: 36981883 PMCID: PMC10049386 DOI: 10.3390/ijerph20064971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Caffeine is a psychostimulant that is well known to mitigate the deleterious effects of sleep debt. Our aim was to assess the effects of acute caffeine intake on cognitive vulnerability and brain activity during total sleep deprivation (TSD), taking into account habitual caffeine consumption. (2) Methods: Thirty-seven subjects were evaluated in a double-blind, crossover, total sleep deprivation protocol with caffeine or placebo treatment. Vigilant attention was evaluated every six hours during TSD using the psychomotor vigilance test (PVT) with EEG recordings. The influence of habitual caffeine consumption was analyzed by categorizing subjects into low, moderate, and high consumers. (3) Results: The PVT reaction time (RT) increased during TSD and was lower in the caffeine condition vs. the placebo condition. The RT was shorter in the low-caffeine consumers compared to moderate and high consumers, regardless of conditions and treatments. The TSD-related increase in EEG power was attenuated by acute caffeine intake independently of habitual caffeine consumption, and the individual alpha frequency (IAF) was lower in the high-consumption group. The IAF was negatively correlated with daytime sleepiness. Moreover, a correlation analysis showed that the higher the daily caffeine consumption, the higher the RT and the lower the IAF. (4) Conclusions: A high level of habitual caffeine consumption decreases attentional performance and alpha frequencies, decreasing tolerance to sleep deprivation.
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Affiliation(s)
- Michael Quiquempoix
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Catherine Drogou
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Mégane Erblang
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (UMR LBEPS), Université d’Evry, 91025 Evry-Courcouronnes, France
| | - Pascal Van Beers
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Mathias Guillard
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Pierre-Emmanuel Tardo-Dino
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (UMR LBEPS), Université d’Evry, 91025 Evry-Courcouronnes, France
| | - Arnaud Rabat
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Damien Léger
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
- APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, 75004 Paris, France
| | - Mounir Chennaoui
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Danielle Gomez-Merino
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
| | - Fabien Sauvet
- Institut de Recherche Biomédicale des Armées (IRBA), 91223 Brétigny sur Orge, France (F.S.)
- URP 7330 VIFASOM, Université Paris Cité, Hôtel-Dieu, 75004 Paris, France
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Lin YS, Weibel J, Landolt HP, Santini F, Slawik H, Borgwardt S, Cajochen C, Reichert CF. Brain activity during a working memory task after daily caffeine intake and caffeine withdrawal: a randomized double-blind placebo-controlled trial. Sci Rep 2023; 13:1002. [PMID: 36653409 PMCID: PMC9849460 DOI: 10.1038/s41598-022-26808-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/20/2022] [Indexed: 01/19/2023] Open
Abstract
Acute caffeine intake has been found to increase working memory (WM)-related brain activity in healthy adults without improving behavioral performances. The impact of daily caffeine intake-a ritual shared by 80% of the population worldwide-and of its discontinuation on working memory and its neural correlates remained unknown. In this double-blind, randomized, crossover study, we examined working memory functions in 20 young healthy non-smokers (age: 26.4 ± 4.0 years; body mass index: 22.7 ± 1.4 kg/m2; and habitual caffeine intake: 474.1 ± 107.5 mg/day) in a 10-day caffeine (150 mg × 3 times/day), a 10-day placebo (3 times/day), and a withdrawal condition (9-day caffeine followed by 1-day placebo). Throughout the 10th day of each condition, participants performed four times a working memory task (N-Back, comprising 3- and 0-back), and task-related blood-oxygen-level-dependent (BOLD) activity was measured in the last session with functional magnetic resonance imaging. Compared to placebo, participants showed a higher error rate and a longer reaction time in 3- against 0-back trials in the caffeine condition; also, in the withdrawal condition we observed a higher error rate compared to placebo. However, task-related BOLD activity, i.e., an increased attention network and decreased default mode network activity in 3- versus 0-back, did not show significant differences among three conditions. Interestingly, irrespective of 3- or 0-back, BOLD activity was reduced in the right hippocampus in the caffeine condition compared to placebo. Adding to the earlier evidence showing increasing cerebral metabolic demands for WM function after acute caffeine intake, our data suggest that such demands might be impeded over daily intake and therefore result in a worse performance. Finally, the reduced hippocampal activity may reflect caffeine-associated hippocampal grey matter plasticity reported in the previous analysis. The findings of this study reveal an adapted neurocognitive response to daily caffeine exposure and highlight the importance of classifying impacts of caffeine on clinical and healthy populations.
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Affiliation(s)
- Yu-Shiuan Lin
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm-Klein Strasse 27, 4002, Basel, Switzerland. .,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland. .,Neuropsychiatry and Brain Imaging, Psychiatric Hospital of the University of Basel, Basel, Switzerland.
| | - Janine Weibel
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm-Klein Strasse 27, 4002, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Sleep and Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - Francesco Santini
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Helen Slawik
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm-Klein Strasse 27, 4002, Basel, Switzerland.,Clinical Sleep Laboratory, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Neuropsychiatry and Brain Imaging, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm-Klein Strasse 27, 4002, Basel, Switzerland. .,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
| | - Carolin Franziska Reichert
- Centre for Chronobiology, University Psychiatric Clinics Basel, Wilhelm-Klein Strasse 27, 4002, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
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7
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Reichert CF, Deboer T, Landolt HP. Adenosine, caffeine, and sleep-wake regulation: state of the science and perspectives. J Sleep Res 2022; 31:e13597. [PMID: 35575450 PMCID: PMC9541543 DOI: 10.1111/jsr.13597] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 01/11/2023]
Abstract
For hundreds of years, mankind has been influencing its sleep and waking state through the adenosinergic system. For ~100 years now, systematic research has been performed, first started by testing the effects of different dosages of caffeine on sleep and waking behaviour. About 70 years ago, adenosine itself entered the picture as a possible ligand of the receptors where caffeine hooks on as an antagonist to reduce sleepiness. Since the scientific demonstration that this is indeed the case, progress has been fast. Today, adenosine is widely accepted as an endogenous sleep‐regulatory substance. In this review, we discuss the current state of the science in model organisms and humans on the working mechanisms of adenosine and caffeine on sleep. We critically investigate the evidence for a direct involvement in sleep homeostatic mechanisms and whether the effects of caffeine on sleep differ between acute intake and chronic consumption. In addition, we review the more recent evidence that adenosine levels may also influence the functioning of the circadian clock and address the question of whether sleep homeostasis and the circadian clock may interact through adenosinergic signalling. In the final section, we discuss the perspectives of possible clinical applications of the accumulated knowledge over the last century that may improve sleep‐related disorders. We conclude our review by highlighting some open questions that need to be answered, to better understand how adenosine and caffeine exactly regulate and influence sleep.
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Affiliation(s)
- Carolin Franziska Reichert
- Centre for Chronobiology, University Psychiatric Clinics Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Center for Affective, Stress, and Sleep Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Tom Deboer
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans-Peter Landolt
- Institute of Pharmacology and Toxicology, University of Zürich, Zürich, Switzerland.,Sleep & Health Zürich, University Center of Competence, University of Zürich, Zürich, Switzerland
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Ledesma ALL, Leite Rodrigues D, Monteiro de Castro Silva I, Oliveira CA, Bahmad F. The effect of caffeine on tinnitus: Randomized triple-blind placebo-controlled clinical trial. PLoS One 2021; 16:e0256275. [PMID: 34543285 PMCID: PMC8452027 DOI: 10.1371/journal.pone.0256275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To test the hypothesis that caffeine can influence tinnitus, we recruited 80 patients with chronic tinnitus and randomly allocated them into two groups (caffeine and placebo) to analyze the self-perception of tinnitus symptoms after caffeine consumption, assuming that this is an adequate sample for generalization. Methods The participants were randomized into two groups: one group was administered a 300-mg capsule of caffeine, and the other group was given a placebo capsule (cornstarch). A diet that restricted caffeine consumption for 24 hours was implemented. The participants answered questionnaires (the Tinnitus Handicap Inventory—THI, the Visual Analog Scale—VAS, the profile of mood state—POMS) and underwent examinations (tonal and high frequency audiometry, acufenometry (frequency measure; intensity measure and the minimum level of tinnitus masking), transient otoacoustic emissions—TEOAE and distortion product otoacoustic emissions—DPOAE assessments) at two timepoints: at baseline and after capsule ingestion. Results There was a significant change in mood (measured by the POMS) after caffeine consumption. The THI and VAS scores were improved at the second timepoint in both groups. The audiometry assessment showed a significant difference in some frequencies between baseline and follow-up measurements in both groups, but these differences were not clinically relevant. Similar findings were observed for the amplitude and signal-to-noise ratio in the TEOAE and DPOAE measurements. Conclusions Caffeine (300 mg) did not significantly alter the psychoacoustic measures, electroacoustic measures or the tinnitus-related degree of discomfort.
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Affiliation(s)
- Alleluia Lima Losno Ledesma
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
| | | | | | - Carlos Augusto Oliveira
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
| | - Fayez Bahmad
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
- Institute of Otorhinolaryngology, Brasília, DF, Brazil
- * E-mail:
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9
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Casale CE, Goel N. Genetic Markers of Differential Vulnerability to Sleep Loss in Adults. Genes (Basel) 2021; 12:1317. [PMID: 34573301 PMCID: PMC8464868 DOI: 10.3390/genes12091317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this review, we discuss reports of genotype-dependent interindividual differences in phenotypic neurobehavioral responses to total sleep deprivation or sleep restriction. We highlight the importance of using the candidate gene approach to further elucidate differential resilience and vulnerability to sleep deprivation in humans, although we acknowledge that other omics techniques and genome-wide association studies can also offer insights into biomarkers of such vulnerability. Specifically, we discuss polymorphisms in adenosinergic genes (ADA and ADORA2A), core circadian clock genes (BHLHE41/DEC2 and PER3), genes related to cognitive development and functioning (BDNF and COMT), dopaminergic genes (DRD2 and DAT), and immune and clearance genes (AQP4, DQB1*0602, and TNFα) as potential genetic indicators of differential vulnerability to deficits induced by sleep loss. Additionally, we review the efficacy of several countermeasures for the neurobehavioral impairments induced by sleep loss, including banking sleep, recovery sleep, caffeine, and naps. The discovery of reliable, novel genetic markers of differential vulnerability to sleep loss has critical implications for future research involving predictors, countermeasures, and treatments in the field of sleep and circadian science.
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Affiliation(s)
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA;
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10
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Honn KA. 24 th international symposium on shiftwork and working time: innovations in research and practice improving shiftworker health & safety. Chronobiol Int 2021; 37:1273-1282. [PMID: 33957058 DOI: 10.1080/07420528.2020.1831719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Kimberly A Honn
- Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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11
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Erblang M, Sauvet F, Drogou C, Quiquempoix M, Van Beers P, Guillard M, Rabat A, Trignol A, Bourrilhon C, Erkel MC, Léger D, Thomas C, Gomez-Merino D, Chennaoui M. Genetic Determinants of Neurobehavioral Responses to Caffeine Administration during Sleep Deprivation: A Randomized, Cross Over Study (NCT03859882). Genes (Basel) 2021; 12:555. [PMID: 33920292 PMCID: PMC8069049 DOI: 10.3390/genes12040555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 02/06/2023] Open
Abstract
This study investigated whether four single nucleotide polymorphisms (SNPs) moderated caffeine effects on vigilance and performance in a double-blind and crossover total sleep deprivation (TSD) protocol in 37 subjects. In caffeine (2 × 2.5 mg/kg/24 h) or placebo-controlled condition, subjects performed a psychomotor vigilance test (PVT) and reported sleepiness every six hours (Karolinska sleepiness scale (KSS)) during TSD. EEG was also analyzed during the 09:15 PVT. Carriers of the TNF-α SNP A allele appear to be more sensitive than homozygote G/G genotype to an attenuating effect of caffeine on PVT lapses during sleep deprivation only because they seem more degraded, but they do not perform better as a result. The A allele carriers of COMT were also more degraded and sensitive to caffeine than G/G genotype after 20 h of sleep deprivation, but not after 26 and 32 h. Regarding PVT reaction time, ADORA2A influences the TSD effect but not caffeine, and PER3 modulates only the caffeine effect. Higher EEG theta activity related to sleep deprivation was observed in mutated TNF-α, PER3, and COMT carriers, in the placebo condition particularly. In conclusion, there are genetic influences on neurobehavioral impairments related to TSD that appear to be attenuated by caffeine administration. (NCT03859882).
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Affiliation(s)
- Mégane Erblang
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025 Evry, France;
| | - Fabien Sauvet
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Catherine Drogou
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Michaël Quiquempoix
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Pascal Van Beers
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Mathias Guillard
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Arnaud Rabat
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Aurélie Trignol
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Cyprien Bourrilhon
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025 Evry, France;
| | - Marie-Claire Erkel
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Damien Léger
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
- APHP, Hôtel-Dieu, Centre du sommeil et de la Vigilance, 75004 Paris, France
| | - Claire Thomas
- LBEPS, Univ Evry, IRBA, Université Paris Saclay, 91025 Evry, France;
| | - Danielle Gomez-Merino
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
| | - Mounir Chennaoui
- Institut de Recherche Biomédicale des Armées (IRBA), 91190 Brétigny sur Orge, France; (M.E.); (C.D.); (M.Q.); (P.V.B.); (M.G.); (A.R.); (A.T.); (C.B.); (M.-C.E.); (D.G.-M.); (M.C.)
- EA VIFASOM (EA 7330 Vigilance, Fatigue, Sommeil et Santé Publique), Université de Paris, 75004 Paris, France;
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12
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Erwin JA, Skeiky L, Satterfield BC, Paech GM, Layton ME, Van Dongen HPA, Hansen DA. Robustness of inter-individual differences in slow wave sleep for daytime sleep periods after total sleep deprivation with or without caffeine administration: potential implications for around-the-clock operations. Chronobiol Int 2020; 37:1465-1468. [PMID: 32954864 DOI: 10.1080/07420528.2020.1817931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There are large inter-individual differences in slow wave sleep, which constitute a trait or phenotype. We investigated whether the manifestation of this trait is impacted by daytime sleeping after sleep deprivation, and to what extent it is robust to prior caffeine intake. N = 12 subjects underwent three 48 h periods of total sleep deprivation with different caffeine dosing regimens. There were significant, considerable, and robust inter-individual differences in slow wave sleep across nighttime sleep opportunities before, and daytime sleep after, total sleep deprivation, regardless of caffeine dosing. The robustness of this phenotype may have functional implications for individuals in around-the-clock operational settings.
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Affiliation(s)
- Julie A Erwin
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Lillian Skeiky
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Brieann C Satterfield
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Gemma M Paech
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, Australia
| | - Matthew E Layton
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Devon A Hansen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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13
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Skeiky L, Brager AJ, Satterfield BC, Petrovick M, Balkin TJ, Capaldi VF, Ratcliffe RH, Van Dongen HPA, Hansen DA. TNFα G308A genotype, resilience to sleep deprivation, and the effect of caffeine on psychomotor vigilance performance in a randomized, double-blind, placebo-controlled, crossover study. Chronobiol Int 2020; 37:1461-1464. [PMID: 32933332 DOI: 10.1080/07420528.2020.1821044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The TNFα G308A gene polymorphism has been reported to influence performance impairment during total sleep deprivation (TSD). We investigated this effect in a randomized, double-blind, crossover laboratory study of repeated exposure to 48 h TSD with caffeine administration at different doses. In a retrospective analysis, we replicated the finding that the A allele of TNFα G308A, found in 4 of 12 study participants, confers resilience to performance impairment during TSD. There was no evidence of an interaction of TNFα genotype with the beneficial effect of caffeine (200 or 300 mg) on performance during TSD, suggesting distinct underlying mechanisms.
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Affiliation(s)
- Lillian Skeiky
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Allison J Brager
- Sleep Research Center, Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Brieann C Satterfield
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Martha Petrovick
- Group 49 - Biological and Chemical Technologies, MIT Lincoln Labs, Lexington, MA, USA
| | - Thomas J Balkin
- Sleep Research Center, Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Vincent F Capaldi
- Sleep Research Center, Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Ruthie H Ratcliffe
- Sleep Research Center, Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Devon A Hansen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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14
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Aldosari MS, Olaish AH, Nashwan SZ, Abulmeaty MMA, BaHammam AS. The effects of caffeine on drowsiness in patients with narcolepsy: a double-blind randomized controlled pilot study. Sleep Breath 2020; 24:1675-1684. [PMID: 32215834 DOI: 10.1007/s11325-020-02065-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The effects of caffeine on drowsiness and reaction time in patients with narcolepsy are unclear. We aimed to assess the effects of caffeine as add-on therapy in narcolepsy patients. METHODS A randomized, double-blind, placebo-control clinical pilot trial was conducted with a parallel, two-arm trial allocation ratio of 1:1. Participants attended two study visits 7 days apart. The drug was administered orally in a single opaque capsule containing 200 mg caffeine/placebo daily in the morning for 1 week. Sleepiness was assessed objectively using infrared reflectance oculography to measure the percentage of long eye closure (LEC%) and subjectively using two sleepiness scales, the Stanford Sleepiness Scale (SSS) and Karolinska Sleepiness Scale (KSS). Parameters were measured at baseline (BL) prior to taking the drug, after taking the first dose (FD), and after 1 week (WD) of daily caffeine. RESULTS Sixteen participants with narcolepsy were included. No significant differences between groups in baseline measurements were observed. LEC% was significantly decreased after the FD and WD compared with baseline levels (BL 1.4 ± 2.1 vs. FD 0.06 ± 0.0.6 and WD 0.03 ± 0.04). Significant improvements in alertness were observed using the KSS when comparing BL with FD and WD (6.3 ± 1.6, 4.9 ± 1.7, and 4.7 ± 1.7, respectively; p = 0.01). No changes in reaction time or SSS scores were noted. CONCLUSION Our findings suggest that a small dose of caffeine has positive effects on alertness in patients with narcolepsy. However, larger trials are required to confirm these findings. TRIAL REGISTRATION NO ClinicalTrial.gov NCT02832336.
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Affiliation(s)
- Mona S Aldosari
- Clinical Nutrition Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Awad H Olaish
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia
| | - Samar Z Nashwan
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud M A Abulmeaty
- Clinical Nutrition Program, Community Health Sciences, King Saud University, Riyadh, Saudi Arabia. .,Obesity Management and Research Unit, Medical Physiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia. .,The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in Saudi Arabia (08-MED511-02), Riyadh, Saudi Arabia.
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15
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Good CH, Brager AJ, Capaldi VF, Mysliwiec V. Sleep in the United States Military. Neuropsychopharmacology 2020; 45:176-191. [PMID: 31185484 PMCID: PMC6879759 DOI: 10.1038/s41386-019-0431-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/23/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023]
Abstract
The military lifestyle often includes continuous operations whether in training or deployed environments. These stressful environments present unique challenges for service members attempting to achieve consolidated, restorative sleep. The significant mental and physical derangements caused by degraded metabolic, cardiovascular, skeletomuscular, and cognitive health often result from insufficient sleep and/or circadian misalignment. Insufficient sleep and resulting fatigue compromises personal safety, mission success, and even national security. In the long-term, chronic insufficient sleep and circadian rhythm disorders have been associated with other sleep disorders (e.g., insomnia, obstructive sleep apnea, and parasomnias). Other physiologic and psychologic diagnoses such as post-traumatic stress disorder, cardiovascular disease, and dementia have also been associated with chronic, insufficient sleep. Increased co-morbidity and mortality are compounded by traumatic brain injury resulting from blunt trauma, blast exposure, and highly physically demanding tasks under load. We present the current state of science in human and animal models specific to service members during- and post-military career. We focus on mission requirements of night shift work, sustained operations, and rapid re-entrainment to time zones. We then propose targeted pharmacological and non-pharmacological countermeasures to optimize performance that are mission- and symptom-specific. We recognize a critical gap in research involving service members, but provide tailored interventions for military health care providers based on the large body of research in health care and public service workers.
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Affiliation(s)
- Cameron H. Good
- 0000 0001 2151 958Xgrid.420282.ePhysical Scientist, US Army Research Laboratory, Aberdeen Proving Ground, MD, 21005 USA
| | - Allison J. Brager
- 0000 0001 0036 4726grid.420210.5Sleep Research Center, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910 USA
| | - Vincent F. Capaldi
- 0000 0001 0036 4726grid.420210.5Department of Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Silver Spring, MD 20910 USA
| | - Vincent Mysliwiec
- 0000 0004 0467 8038grid.461685.8San Antonio Military Health System, Department of Sleep Medicine, JBSA, Lackland, TX 78234 USA
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Crooks E, Hansen DA, Satterfield BC, Layton ME, Van Dongen HPA. Cardiac autonomic activity during sleep deprivation with and without caffeine administration. Physiol Behav 2019; 210:112643. [PMID: 31398441 DOI: 10.1016/j.physbeh.2019.112643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/15/2019] [Accepted: 08/05/2019] [Indexed: 11/30/2022]
Abstract
Caffeine is often consumed to mitigate degraded alertness associated with sleep deprivation. Both caffeine and sleep deprivation have been implicated in cardiovascular disease, but evidence is largely anecdotal. We determined the effects of sleep deprivation and caffeine on markers of cardiac autonomic activity. Twelve healthy young adults completed an 18-day laboratory study. They were exposed to three 48 h sessions of acute total sleep deprivation (TSD), each separated by three recovery days. In randomized, counter-balanced order, subjects received 0 mg (placebo), 200 mg, or 300 mg of caffeine at 12 h intervals during each sleep deprivation session. Every 2 h during scheduled wakefulness, a 15-minute neurobehavioral task battery was administered, during which heart rate (HR) and the high frequency (HF) component of the HR variability power spectrum (HF-HRV) were measured. Caffeine administration decreased HR and increased HF-HRV, indicating elevated parasympathetic activity. The 300 mg caffeine dose did not significantly affect autonomic activity to a greater extent than the 200 mg dose. There was no significant effect of 48 h of TSD on HR, whereas there was a small increase across hours awake in HF-HRV. There was no significant interaction of TSD with caffeine. Circadian rhythmicity in HR and HF-HRV surpassed the magnitude of the effects of caffeine and TSD. Caffeine and acute TSD thus produced only modest changes in cardiac autonomic activity, unlikely to have immediate clinical implications in healthy young adults. However, further research is needed to determine the long-term effects of chronic exposure to sleep loss and/or caffeine on cardiac health, and to determine the generalizability of our findings to non-healthy populations.
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Affiliation(s)
- Elena Crooks
- Sleep and Performance Research Center, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA; Department of Physical Therapy, Eastern Washington University, 310 N. Riverpoint Blvd., Spokane, WA 99202-0002, USA.
| | - Devon A Hansen
- Sleep and Performance Research Center, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA; Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA.
| | - Brieann C Satterfield
- Social, Cognitive, and Affective Neuroscience Lab, University of Arizona College of Medicine, PO Box 245002, Tucson, AZ 85724-5002, USA.
| | - Matthew E Layton
- Sleep and Performance Research Center, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA; Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA.
| | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA; Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA.
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