Military Study Shows Excess Consumption of Energy Drinks Can Paradoxically Increase Sleep Problems and Daytime Sleepiness

Walter Reed Army Institute of Research analyzed data collected regarding armed service members in Afghanistan in 2010 to determine the extent of energy drink use and the association with sleep problems and sleepiness during combat operations. The analysis showed that 44.8% of deployed service members consumed at least one energy drink daily, with 13.9% drinking three or more a day.

Service members drinking three or more energy drinks a day were significantly more likely to report sleeping 4 hours or less a night on average than those consuming two drinks or fewer. 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 who consumed one to two energy drinks did not experience differences in sleep disruption and daytime sleepiness from those not consuming energy drinks.

The results of the study were published in last week’s Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.

The CDC report references civilian studies whose results, consistent with the military study, demonstrate that caffeine use contributes to daytime sleepiness and sleep problems, and that inadequate sleep and daytime sleepiness can impair work productivity. Service members who consumed three or more energy drinks per day reported significantly greater sleep disruption because of combat stress, personal issues, and illness, but not because of external factors. This is similar to results found in a civilian study in which caffeine use caused an increase in nocturnal worry and sleeplessness and a military study that found that mental health symptoms increased energy drink use.

Approximately 6% of adolescent and young adult males in U.S. civilian and military populations consume energy drinks daily. Beverages marketed as energy drinks are targeted at young males, with some brands containing the caffeine equivalent of 1–3 cups of coffee or cans of soda. The effects of caffeine and the amount of consumption of caffeine that can be considered safe for adolescents are not established. 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.

In recent weeks, the U.S. Food and Drug Administration (FDA) has confirmed or disclosed a total of 18 filings involving fatalities and over 150 others involving injuries that mentioned one of four top-selling energy drinks — Red Bull, Monster Energy, Rockstar and 5-Hour Energy. Federal officials have received reports of 13 deaths over the last four years that cited the possible involvement of 5-Hour Energy. Last month, the FDA acknowledged it had received five fatality filings mentioning the popular energy drink Monster Energy.

The Substance Abuse and Mental Health Services Administration, a federal agency, reported late last year that more than 13,000 emergency room visits in 2009 were associated with energy drinks alone.

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