For assistance, please send e-mail to: mmwrq cdc. Type Accommodation and the title of the report in the subject line of e-mail. Beverages marketed as energy drinks have become a popular form of caffeine consumption targeted at young males, with some brands containing the caffeine equivalent of 1—3 cups of coffee or cans of soda 1. Energy drinks also include other ingredients intended to boost physical energy or mental alertness, such as herbal substances, amino acids, sugars, and sugar derivatives; however, caffeine is the main active ingredient 1.
These products generally are unregulated and can have negative side effects e. Paradoxically, excess consumption also can increase sleep problems and daytime sleepiness, which can impair performance 1.
The analysis showed that No differences by age or rank were found. Those who drank three or more drinks a day also were more likely to report sleep disruption related to stress and illness and were more likely to fall asleep during briefings or on guard duty.
Service members should be educated regarding the potential adverse effects of excessive energy drink consumption on sleep and mission performance and should be encouraged to moderate their energy drink consumption in combat environments. Mental Health Advisory Teams conduct comprehensive mental health surveillance of U. The survey version used by J-MHAT 7 to collect data in Afghanistan during the summer of asked about demographic characteristics, deployment history, combat experiences, mental health, deployment stressors, family and relationship concerns, work environment, sleep difficulties and daytime sleepiness, health-care utilization, and various health behaviors, including energy drink consumption.
In total, 1, service members were surveyed using a cluster sample of randomly selected U. Army and Marine combat platoons deployed to Afghanistan. All participants were male, because of the type of unit surveyed. Of those surveyed, 1, consented to have their data used for research purposes and answered the following question: "How many energy drinks e. Service members also were asked about their use of sleep medication, average number of hours of sleep per day, concerns regarding lack of sleep, disruptions to sleep, and work impairment associated with sleepiness Table 1.
For comparison across sleep outcomes, energy drink use was divided into the following categories: no drinks, one to two drinks, and three or more drinks per day. These cutoffs were chosen because previous research demonstrated that mg of caffeine, the equivalent of one to two energy drinks, improved cognitive performance in a military population 4. Prevalence rates of energy drink use are reported. Post hoc analyses of the chi-square tests were conducted by examining discrepancies between observed and expected values for standardized residuals to produce z-scores and identify those cells contributing to the significant differences.
The Sidak-Bonferroni correction was used to account for conducting multiple post hoc tests. Service members surveyed were predominantly on active duty The prevalence of daily energy drink use was Of those reporting daily energy drink use, No associations were found between the proportion of service members reporting the number of drinks used per day i. The groups did not differ in their levels of concern regarding not getting enough sleep.
Service members drinking three or more energy drinks per day were significantly more likely than the other groups to report sleep disruption on more than half the nights in the past 30 days because of stress related to combat, stress related to personal life, and illness.
However, no differences were noted in sleep disruption because of the sleep environment, high operational tempo, nighttime duties, or leisure activities. Service members who drank three or more energy drinks per day also were significantly more likely to report sometimes or often falling asleep while sitting in briefings or while on guard duty, but not while riding in convoys. No differences in energy drink consumption were found related to having had an accident or making a mistake that affected the mission because of sleepiness Table 3.
Despite a significant, omnibus chi-squared association, after post-hoc analyses were conducted, no differences were found in sleep medication use or receiving prescriptions for sleep medications while deployed by levels of energy drink consumption Table 3.
Across sleep disruption and daytime sleepiness outcomes, service members who consumed one to two energy drinks did not differ from those not consuming energy drinks. Robin L. Kok, Maurice L. Corresponding contributor: Robin L. Toblin, robin. Clearly, more research is needed to uncover the skinny on sleep and body weight. Sleep deprivation has also been linked to hypertension, type 2 diabetes, heart attack, and stroke.
As in the case of obesity, the link may be direct or indirect, causal or not. In fact, obesity increases the risk of all of these conditions.
Insomnia: Restoring restful sleep
A number of dietary supplements are heavily promoted to improve sleep. None is subject to FDA standards for purity, safety, or effectiveness. The two most popular supplements are melatonin and valerian. Melatonin is a hormone produced by the brain's pineal gland; in low doses, it may have some benefit for temporary insomnia due to jet leg.
Valerian is an herb; there is little evidence that it helps. Sleeping pills are available over the counter or by prescription. Whether you're treating yourself or using a drug prescribed by your doctor, you should follow several basic guidelines:. Don't take a pill every night. Instead, use medication only when an uninterrupted night's sleep is really important. Even then, restrict yourself to two to four tablets per week.
Over-the-counter medications. Many brands are available. Most contain antihistamines such as diphenhydramine or doxylamine. Most sleep experts discourage the use of these products, particularly long-term use. Side effects include daytime sedation, dry mouth, constipation, and difficulty urinating. Prescription medications. Your doctor will decide if you need a sleeping medication, then determine which drug is best for you and instruct you in its proper use, precautions, and potential side effects.
The FDA has recently required stronger warnings about daytime sedation, untoward behavior such as sleep-driving, and allergic reactions. Many medications are available. The older barbiturates and sedatives have been almost entirely replaced by safer and more effective drugs. Certain antidepressants can help promote sleep, particularly if depression is also present. Examples include trazodone Desyrel , doxepin Sinequan and Adapin and amitriptyline Elavil and others. But doctors today usually choose among three groups of medications:.
Temazepam Restoril , oxazepam Serax , estazolam ProSom , and many others. These older drugs were once the mainstays of insomnia therapy. But excessive use can be habit forming, and some of the longer-acting preparations can cause daytime sedation. Eszopiclone Lunesta , zaleplon Sonata , zolpidem Ambien. These newer medications act on the same receptor in the brain as the benzodiazepines, but they tend to act more quickly and to leave the body faster.
They are less likely to cause daytime sedation, habituation, and rebound insomnia. Melatonin receptor agonist. Ramelteon Rozerem. This medication acts on the same brain receptors as the hormone melatonin. It is fast acting but very short lasting. It does not appear to cause habituation or rebound insomnia. People who are ill or elderly need daytime naps. So do people who suffer from sleep deprivation.
What Causes Insomnia? | National Sleep Foundation
That's why napping appears to be associated with poor health. But voluntary napping is another matter. In fact, studies in shift workers, airline crews, and others show that "power naps" as short as 20 minutes can improve alertness, psychomotor performance, and mood. And a study from Greece linked voluntary siestas to protection from cardiovascular disease, especially in working men.
For best results, plan to fit your snooze into your normal sleep-wake cycle; early afternoon is usually best. Two studies of older adults found that daytime napping didn't interfere with nighttime sleep.
It's reassuring, but if your nap is too long you may find yourself awake in bed at night; 20 to 40 minutes is a good target. And give yourself time to wake up fully before getting back to work; 10 to 15 minutes will usually be enough to get the cobwebs out. According to the National Sleep Foundation, the average American adult gets 6. But about 70 million of us sleep poorly, and for more than half, it's a long-term problem. Nearly everyone can benefit from improved sleep hygiene. Men with sleep disorders should work with their doctors to diagnose the problem and treat conditions that may be responsible.
If your doctor diagnoses primary insomnia, consider behavioral therapy first, and then discuss the proper use of prescription sleeping pills.