Behavior, Sleep, and Problematic Caffeine Consumption in a College-Aged Sample

Coffee and energy drink use patterns in college freshmen: associations with adverse health behaviors and risk factors

Background

Public health concern over college students mixing caffeine-containing energy drinks (EDs) and alcohol has contributed to an array of ED-focused research studies. One review found consistent associations between ED use and heavy/problem drinking as well as other drug use and risky behaviors (Nutr Rev 72:87–97, 2014). The extent to which similar patterns exist for other sources of caffeine is not known. The present study examined associations between coffee and ED consumption and alcohol, tobacco and other drug use; alcohol use problems; and parental substance abuse and mental health problems in a sample of college freshmen.

Methods

Subjects were N = 1986 freshmen at an urban university who completed an on-line survey about demographics; caffeine; alcohol, tobacco and other drug use; and family history. The sample was 61% female and 53% White. Chi-square analyses and multivariable binary or ordinal logistic regression were used to compare substance use, problem alcohol behavior, and familial risk measures across 3 caffeine use groups: ED (with or without Coffee) (ED + Co; N = 350); Coffee but no ED (Co; N = 761); and neither coffee nor ED (NoCE; N = 875) use.

Results

After adjusting for gender and race, the 3 caffeine use groups differed on 8 of 9 symptoms for alcohol dependence. In all cases, the ED + Co group was most likely to endorse the symptom, followed by the Co group and finally the NoCE group (all p < .002). A similar pattern was found for: use 6+ times of 5 other classes of drugs (all p < .05); extent of personal and peer smoking (all p < .001); and paternal problems with alcohol, drugs and anxiety/depression as well as maternal alcohol problems and depression/anxiety (p < .04).

Conclusions

The response pattern was ubiquitous, with ED + Co most likely, Co intermediate, and NoCE least likely to endorse a broad range of substance use, problem alcohol behaviors, and familial risk factors. The finding that the Co group differed from both the ED + Co and NoCE groups on 8 measures and from the NoCE group on one additional measure underscores the importance of looking at coffee in addition to EDs when considering associations between caffeine and other risky behaviors.

Determinants of sleep quality in college students: A literature review

PURPOSE

To review the various determinants of sleep quality among college students.

METHODS

The PubMed, Web of Science and Cochrane Library databases were searched with the search string "sleep quality" AND "college students" for articles published between January 2007 and October 2017. Articles were excluded if they (1) examined sleep quality as a risk factor for other outcomes or (2) involved inpatients or participants under medical care.

RESULTS

The 112 identified studies were classified into categories according to the investigated determinants and their effect on sleep quality. Physical activity and healthy social relations improved sleep quality, while caffeine intake, stress and irregular sleep-wake patterns decreased sleep quality. Less consistent results were reported regarding eating habits and sleep knowledge, while proper napping during the day might improve overall sleep quality.

CONCLUSIONS

College students are vulnerable to different risk factors for sleep quality. When designing interventions to improve sleep quality among college students, the main determinants need to be taken into consideration.

Does early exposure to caffeine promote smoking and alcohol use behavior? A prospective analysis of middle school students

BACKGROUND AND AIMS

Despite the negative consequences associated with caffeine use among children and youth, its use is increasingly widespread among middle school students. Cross-sectional studies reveal links between caffeine and other substance use. The potential for caffeine use to confer increased vulnerability to substance use, however, has not been investigated using prospective designs. We hypothesized that caffeine use at baseline would be associated positively with increased alcohol use, drunkenness, smoking and e-cigarette use.

DESIGN

Prospective cohort study with 12 months separating baseline from follow-up.

SETTING

West Virginia, USA.

PARTICIPANTS

Middle school students (6th and 7th grades; n = 3932) in three West Virginia (WV) counties provided data at baseline and follow-up 12 months later.

MEASUREMENTS

Youth self-reported their use of caffeine from multiple sources (e.g. soda, energy drinks, coffee and tea), cigarette smoking, electronic cigarette use, alcohol use and drunkenness.

FINDINGS

Cross-lagged path models for individual substance use categories provided a good fit to the data. Controlling for demographic variables and other substance use at baseline, caffeine at time 1 (T1) was associated positively with T2 cigarette smoking (β = 0.27, P = 0.001), e-cigarette use (β = 0.21, P = 0.001), alcohol use (β = 0.17, P = 0.001) and drunkenness (β = 0.15, P = 0.001). Conversely, non-significant relations emerged between three of four substances at T1 and caffeine at T2. Positive relations were found between e-cigarette use at T1 and caffeine use at T2 (β = 0.07, P = 0.006). These findings were supported by an omnibus model with all substances included. Specifically, significant relations were observed between caffeine at T1 and all substance use outcomes at T2, whereas no significant relations were observed between substance use and caffeine over time.

CONCLUSIONS

Caffeine may promote early use of other types of substances among middle school-aged adolescents.

Do Energy Drink Consumers Study More?

The use and motivations for use of energy drinks (EDs) in college students has been documented in the literature. Many college students identify academic reasons, such as a need to study more, as a motivation for ED use. However, research has not determined if users who claim academic motivations actually study more than those who claim other motivations. A sample of 692 undergraduate students at a large, private university completed a paper survey that inquired about demographics, ED use, motivations for ED use, sleep quality, and average amount of time spent sleeping and studying per week. Descriptive statistics were used to analyze demographics, and analysis of variance was used to compare ED users with different motivations to amount of time spent sleeping and studying per week. Regression analysis was also used to determine if ED use could be predicted by any of the other variables. Increased ED consumption was predicted by being male (B = -0.394, p < .001) and having a decreased sleep quality (B = 0.586, p < .001). Reported study hours by subjects who claimed academic reasons as motivation for ED use were not significantly different in comparison to ED users who claimed other motivations. In our sample, ED users who reported academic reasons as motivations for use did not report significantly more study hours per week when compared to those who claimed other motivations. This demonstrates a disconnect between reported motivations for energy drink use and outcomes that are expected to be associated with those motivations.

A gender-specific analysis of adolescent dietary caffeine, alcohol consumption, anger, and violent behavior

Self-reported dietary caffeine and alcohol consumption were examined in relation to anger and violent behavior in Icelandic tenth-graders. Structural equation modeling (SEM) was used to investigate direct and indirect effects of measured and latent variables in the population sample of 3,670, controlling for parental financial standing, family structure, ADHD, and peer delinquency. Gender differences were observed that have not been reported previously, especially in relation to anger as a possible mediator of violent behavior against a background of caffeine and alcohol consumption. Study findings suggest the need to take account of caffeine consumption in relation to adolescent anger and violence.

A survey of college-bound high school graduates regarding circadian preference, caffeine use, and academic performance

BACKGROUND

This study examines the relationships between circadian preference and caffeine use with academic performance and hours spent studying for recent high school graduates entering their first year of college.

METHOD

Entering first-year college students enrolled at 90 baccalaureate-level institutions across the USA were invited to complete the Beginning College Survey of Student Engagement (BCSSE) and the Composite Scale of Morningness (CSM) as well as answer questions regarding caffeine consumption. Surveys were administered on each campus during the summer months of 2013. Only those that graduated from a US high school in the spring of 2013 were included in this study. The final sample for this study included 25,200 students that completed the BCSSE, CSM, and questions regarding caffeine consumption.

RESULTS

Evening types (E-types) were significantly less likely to report earning A/A-'s in high school and less likely to study 16 or more hours per week compared to intermediate or morning types (M-types) (p < 0.05). Overall, entering first-year students reported an average of 1.1 servings of caffeine per day, with 39 % reporting no caffeine consumption. M-types were more likely to consume no caffeine (54 %) compared to E-types that also indicated no daily caffeine (31 %) (p < 0.05). However, E-types were approximately 2.5 times more likely to consume three or more daily servings of caffeine (18 %) compared to M-types that consume the same amount (7 %) (p < 0.05). M-types that consumed no caffeine reported the highest grades with nearly 64 % reporting they earned mostly A's or A-'s in high school. However, the apparent advantage that morning types had over evening types regarding high school grades was completely ameliorated once three or more servings of caffeine were consumed per day.

CONCLUSIONS

This study provides additional information to educators and health professionals to create programs and provide resource to help adolescents better understand the impact of their sleep behaviors and use of caffeine on their academic performance.

Caffeine Use Disorder: A Comprehensive Review and Research Agenda

Caffeine is the most commonly used drug in the world. Although consumption of low to moderate doses of caffeine is generally safe, an increasing number of clinical studies are showing that some caffeine users become dependent on the drug and are unable to reduce consumption despite knowledge of recurrent health problems associated with continued use. Thus, the World Health Organization and some health care professionals recognize caffeine dependence as a clinical disorder. In this comprehensive literature review, we summarize published research on the biological evidence for caffeine dependence; we provide a systematic review of the prevalence of caffeine dependence and rates of endorsement of clinically meaningful indicators of distress and functional impairment among habitual caffeine users; we discuss the diagnostic criteria for Caffeine Use Disorder-a condition for further study included in the Diagnostic and Statistical Manual of Mental Disorders (5^th ed.); and we outline a research agenda to help guide future clinical, epidemiological, and genetic investigations of caffeine dependence. Numerous controlled laboratory investigations reviewed in this article show that caffeine produces behavioral and physiological effects similar to other drugs of dependence. Moreover, several recent clinical studies indicate that caffeine dependence is a clinically meaningful disorder that affects a nontrivial proportion of caffeine users. Nevertheless, more research is needed to determine the reliability, validity, and prevalence of this clinically important health problem.

Adolescent caffeine consumption and self-reported violence and conduct disorder

Caffeine is the most widely used psychoactive substance in the world and currently the only one legally available to children and adolescents. The sale and use of caffeinated beverages has increased markedly among adolescents during the last decade. However, research on caffeine use and behaviors among adolescents is scarce. We investigate the relationship between adolescent caffeine use and self-reported violent behaviors and conduct disorders in a population-based cross-sectional sample of 3,747 10th grade students (15-16 years of age, 50.2 % girls) who were enrolled in the Icelandic national education system during February 2012. Through a series of multiple regression models, while controlling for background factors, Attention Deficit Hyperactivity Disorder symptoms and current medication and peer delinquency, and including measures on substance use, our findings show robust additive explanatory power of caffeine for both violent behaviors and conduct disorders. In addition, the association of caffeine to the outcomes is significantly stronger for girls than boys for both violent behaviors and conduct disorders. Future studies are needed to examine to what extent, if at all, these relationships are causal. Indication of causal connections between caffeine consumption and negative outcomes such as those reported here would call into question the acceptability of current policies concerning the availability of caffeine to adolescents and the targeting of adolescence in the marketing of caffeine products.