Sleep Dynamic Therapy

Archive for the ‘Caffeine’ Category

Interesting video at CNN site on pilots who may have dozed off during a flight. Where’s the caffeine when you really need it?

Several MSM articles like this one covered the just released research showing that there is an association between increased caffeine consumption (measured in coffee, sodas or tea) and miscarriage. Like so many studies before it and the coverage on this topic, the MSM is stuck in neutral as it fails to explore other possible explanations for the findings. The findings, after all, are associations, which means that no one is making any claims that caffeine causes miscarriages. Yet, in all the reports I read, most suggest pregnant women should consider reducing caffeine consumption, but few of them actually asked an expert, let alone a sleep expert, to given an alternate view on the findings.

So, here’s mine. It’s well known that caffeine is used to increase energy and ward off fatigue and sleepiness. Thus, it’s not rocket science to make the assumption that a fair number of heavy caffeine users are suffering from fatigue and sleepiness caused by sleep disorders. A potentially common sleep disorder in pregnant women is sleep-disordered breathing, a condition that causes oxidative stress and pro-inflammatory states, and previous research by the inventor of CPAP (the treatment for sleep apnea), Dr. Colin Sullivan, showed a strong link between sleep breathing problems and pre-eclampsia, a condition in pregnancy that may threaten the fetus.

Thus, a parsimonious theory is that pregnant women with sleep apnea are sufficiently tired and sleepy to reach for an extra cup of coffee, etc. So, what the research then really might be showing is that the excess caffeine drinkers actually suffer from undiagnosed sleep disorders, namely sleep-disordered breathing, which through it’s adverse effects on multiple organ systems in the body increases risk for miscarriages.

How the impact of sleep-disordered breathing (SDB) could produce this particular effect is unknown, but SDB causes a great deal of sympathetic nervous system activation by the constant awakenings triggered by disrupted breathing; and the disrupted breathing itself causes marked fluctuations or desaturations in oxygenation throughout the night. Neither of these two processes are considered healthy for the human body, so the most relevant theory would be that these processes are adversely influencing the physiology of pregnancy and the fetus.

There can be no doubt that caffeine is a miracle drug, because it has probably saved millions of lives by preventing car accidents if not many other workplace accidents. I’m sure physicians have known for years that caffeine enhances work performance in the middle of the night by maintaining necessary degrees of alertness.

So, I’m not knocking caffeine, but in what follows in this post I hope you’ll consider another perspective on caffeine that just might save your life in a way you might not have anticipated.

Let’s start with the fundamental question, “Why do you drink coffee, tea or soda with caffeine?”

Among caffeine users, the single most common answer is, “I like it” and that’s the end of the story.

That’s a fine answer, but I propose that this answer is actually the beginning of the story.

Here are the facts about caffeinated beverage consumption that we see among treatment-seeking sleep patients, which lead us to believe that caffeine use is a marker of something beyond the simple pleasure of enjoying a good cup of coffee and so on:

1. Sleep patients rarely consume these drinks irregularly.
2. Certain types of sleep patients consume more caffeine, on a daily basis, then they are immediately able to measure, that is, they don’t really track it.
3. Most of these sleep patients reach for a caffeine drink during a period of low energy, fatigue or some other state of lower than desired powers of concentration or other mental faculties.
4. Nearly all these sleep patients have spent years engaged in these behaviors.
5. Few of these sleep patients have spent 90 consecutive days, let alone 30 consecutive days, with absolutely no caffeine ingestion.
6. Few have spent a few days or a week without caffeine to help themselves clarify whether there might be a secondary reason for their regular use of the miracle drug.
7. Few sleep patients understand the points made in this list, including the inability to even understand this point, that is, there is something more to understand about caffeine use than simply enjoying it.

So, my view, from my clinical and research experience is that sleep patients have gone so long in using caffeine and see so many people around them engaged in the same behavior, that the only logical conclusion to a caffeine discussion is that “it must be normal.”

This “normalizing” of behavior is one of the greatest barriers to successful treatment of sleep disorders, because sleep patients think everyone sleeps poorly so it too must be “normal.” Caffeine compounds this problem, because caffeine reduces or eliminates the primary symptoms seen in sleep disorders’ patients, namely, sleepiness, fatigue, low energy or poor concentration.

So, yes, caffeine is a miracle drug because it does enhance many behavioral deficits triggered by poor sleep quality or low sleep quantity. Yet, by successfully treating these deficits in the short term, an individual does not connect the dots (or as I say, the “zzzots”) to appreciate that caffeine is covering up a series of symptoms that should in other circumstances lead the individual to seek help for a serious health condition that robs the mind and body of the essential energy needed to function optimally in daily life.

Merry Christmas and please use caffeine to help you drive safely, if necessary tonight.

The interesting question here is who would be more likely to eat dark chocolate, drink green tea, or suffer from hypertension? The answer is an individual with a sleep disorder and the most likely sleep disorder would be sleep-disordered breathing (SDB). SDB fragments your sleep by causing your brain to repeatedly wake up during repeated episodes of obstructed breathing, which you are not aware of because you are asleep at the time, and you tend to fall back asleep in seconds, so you don’t remember the awakening. This sleep fragmentation causes you to feel tired and sleepy during the day, which prompts many people to seek an energy boost in caffeinated products, such as dark chocolate and green tea. SDB-induced sleep fragmentation also has been linked to hypertension