Caffeine, Sleep and DepressionSunil Beta Baskar

December 5, 2009

Thanks to my Dad, my Physician

AbstractThis essay should have been titled “Coffee”, Sleep and Depression.

Caffeine from Coffee is always linked with sleeplesness. There are manywho consume coffee like my younger self in concentrations (Quad espres-sos) avoided by others. I recently was hit by a severe sleeplesness requiringmedical attention and depression. I have been online searching for linksbetween coffee and sleep disorders and avoiding coffee intake post 4pmlike most public health advisories say. It never occurred to me that cof-fee would have a direct correlation and mechanism to induce depression.There are more susceptible individuals like myself. I elaborate in thisshort essay on the link and how best to sever it while I have had myopportunity so to do.

1 CoffeeCoffee is a beverage brewed from roasted seeds commonly referred to as coffeebeans and come from the coffee plant. These seeds are from cherries that growin a plant and are harvested in large plantations. There are many countrieswhich claim to have originated coffee in its modern form. Ethiopia, India andYemen all stake claim to be the originators of use of this beverage. The mostcommon species of plant used is Coffea canephora and Coffea arabica. There areless popular species named iberica, excelsa, stenophylla, mauritana, racemosa.The earliest use of coffee by the Ethiopians or Indians (east Indians) were touse it as a stimulant. The earliest known usage on record today is in the 15thCentury CE. With the advent of the new age “Coffee Shop,” it has becomeone of the most commonly consumed beverages. Health warnings have forcedpeople to take decaffeinated coffee. In South India, the traditional use of a filterto make it a part of breakfast beverages is most common. This is often referredto as filter coffee opposed to commercial alternatives like instant coffee.

2 Preparing CoffeeThe cofee berries are meticulously picked by hand. The flesh of the berry isremoved nowadays by machines and the seeds, hereafter referred to as beansare fermented to remove a layer of mucilage. When the fermentation is finishedthe beans are washed throughly to remove any residue of fermentation. Thisresidue is called coffee wastewater. The pulped coffee is now spread-out and

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dried. In most places where the humidity is high, thermal chambers are usedto dry the coffee. The resulting dried coffee bean is called green coffee. Thisis finally roasted. The roasting is done at the supplier, retailer or at home (ifthe consumer is an enthusiast at this.) The roasted beans finally take on thebrown caramelized colour that is commonly associated with coffee. The roastingprocess itself weakens the caffeine content and is therefore used to control it toa degree (by varying temperature.) Higher the temperature, lower the caffeineand the value of the resulting coffee itself. The roasted beans produce an oilcalled caffeol which provides coffee with its aroma and flavour. Neither thearoma nor the flavor are directly related to the caffeine content. The degree ofroasting is finally determined by the colour of the coffee bean.

The resulting roasted coffee beans are powdered and steam is usually passedthrough the powder in a coffee-maker. The steam condenses through the pow-derand results in a decoction. The condensate is now allowed to pass througha filter to create an extremely strong concentration of coffee. This is the sourceof the espresso and most coffee beverages around the world. This is further di-luted with milk or water and is served with additives like sugar, milk or cream.The caffeine survives this process and is largely responsible for the advertisedadvantages and dangers of coffee. Chicory root is used as a coffee additive or insome cases a substitute.

3 HealthStudies claim that balanced consumption of coffee results in reduction of risks ofAlzheimer’s disease, Parkinson’s disease, Diabetes mellitus type 2, liver cirrhosisand gout. These listed benefits are observed only by those who drink coffee thatcontains caffeine. The metabolism of coffee is directly affected by the enzymaticstate of the liver. The caffeine also contains free radicals (more than the rest ofthe beverage) which are known to have their own advantages in health. Studieshave ruled out that coffee as a risk potential for coronary heart disease. Someclaim that it restores appetite and refreshes olfactory receptors. These claimsgo far enough to suggest that smelling coffee beans after cooking can increasethe appetite of people. Much of this research is not substantiated. Coffee (witha soup of over 1,000 chemicals) has been reported to cause almost 70% bias ininducing carcinoma in rodents.

4 CaffeineCaffeine owes its name to a German Chemist, Ferdinand Runge. He coinedthe term caffeine, literally kaffeine which meant, a chemical compound inkaffe (or coffee.) The primary function of this chemical was to be presentin the beans, leaves and fruits of some plants acting as a natural pesticide. Itkills certain insects feeding on the plants to achieve this. It is found in Kolanuts, Cocoa plants and several sources other than coffee. For those who havemore academic interest, the IUPAC name of the chemical is 1,3,7-trimethyl-1H -purine-2,6(3H,7H )-dione. A simpler name (of all its parts) used is 1,3,7-trimethylxanthine, trimethylxanthine, theine, methyltheobromine.

The content in coffee can vary based on source. The following are proposed

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content for the usual serving of coffee. Arabica is contained the most potentsource of caffeine among the sources of coffee.

• Espresso: 185mg or (2000 mg/L)

• Drip Coffee: 115-175mg or (560-850 mg/L)

• Brewed/Pressed: 80-135mg or (390-650mg/L)

• Instant Coffee: 65-100mg or (310-480mg/L)

• Decaf, brewed: 3-4mg

• Decaf, Instant: 2-3mg

These quantities vary from conventionally published values of caffeine con-tent. Over-the-Counter Medication (for cold, allergy, pain), cococoa, cola alsocontain significant amounts of caffeine. Jolt Colas, Redbull, Yerba Mate, Guaranaand other Energy drinks also sport caffeine as one of their ingredients and con-tain large quantities of them. Some people use such Jolt Colas or Redbull orEnergy drinks to keep them awake late at night for work or studies.

The most common sources of caffeine are:

• Tea

• Coffee

• Chocolate

• Cola

5 Health HazardCaffeine is a well known diuretic. Regular users can develop tolerance to thiseffect according to studies (although I haven’t escaped it.) Heavy consumptioncan result in conditions like significant dehydration. This is the only psychoac-tive substance that can be legally consumed in almost any part of the world.Caffeine is associated with gastroesophageal reflux disease, migraines, arrhyth-mias and sleep disturbance. It also influences access to short-term memory byimproving associated memory, but reducing the ability to recall unrelated ordissociated information. Withdrawal of Coffee (or caffeine in particular) canresult in depression and anxiety with mild migraine.

5.1 Sleep-loss, Depression and CaffeineResearch has indicated that caffeine can interfere with our brain chemistry andtherefore can be a factor in contributing to exacerbating stress, anxiety, panic,depression and insomnia. Caffeine stimulates the release of excess stress hor-mones via its stimulant effects on the adrenal glands. it stimulates the pancreasto secrete insulin which lowers blood sugar so the body has to compensate by re-leasing stress hormones which cause the body to release energy, fat and glucosereserves to stabilize blood sugar levels.

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Caffeine can exacerbate or even cause stress, anxiety, depression and in-somnia because it interferes with a tranquilizing neurotransmitter chemical inthe brain called adenosine. This is the chemical which turns down our anxietylevels - it’s our body’s version of a tranquiliser. Caffeine docks into a recep-tor for adenosine and regular use of caffeine is enough to produce anxiety anddepression in susceptible individuals.

Research indicates that caffeine increases the secretion of stress hormoneslike adrenaline, so if you are already secreting higher stress hormones, caffeinewill boost it even higher and exacerbate stress/anxiety, depression even furtherthan it already is. By eventually cutting caffeine you will lower your stresshormone levels and therefore reduce stress, anxiety and depression.

5.2 Depression and AnxietyClinical Psychologists have carried out research in the USA which indicatesthat caffeine can be a factor in causing or exacerbating depression and that onremoval of caffeine from the diet, depression lifts, and on re-introducing it tothe diet again, depression worsens. Caffeine can have an anti-depressant actionin small amounts but can have a depressive effect in larger amounts. Caffeineusers report significantly higher depression scores when compared to non-users.The higher the total caffeine intake, the more likely the subjects were to sufferfrom depression. The researchers were unable to identify a clear cut dosage levelwhich produced symptoms.

Vitamin B6 is one vitamin involved in the manufacture of serotonin (thischemical is low in people with anxiety and depression). Caffeine depletes thebody of vitamin B6, this may be another route where caffeine is involved indepression.

Dr James Lee, a psychiatrist at Duke University, North Carolina in the USA,said of caffeine and anxiety, “Moderate caffeine consumption makes a personreact like he/she is having a very stressful day. If you combine the effects of realstress with the artificial boost in stress hormones that comes from caffeine thenyou have compounded the effects considerably.” During his study the volunteersproduced 32% more adrenaline, their blood pressure was raised and their heartrates were faster.

By avoiding caffeine you may reduce panic, palpitations etc, and be able toreduce medication or remove it altogether in some people

5.3 Withdrawal EffectsSudden withdrawl from caffeine can cause uncomfortable side effects like headaches.So it is wise to gradually reduce our caffeine intake over a number of weeks. Youcan substitute caffeinated beverages for non-caffeinated versions found in localhealth food shops.

Caffeine can cause unpleasant symptoms and can aggravate many healthproblems such as - Irritability, Insomnia, Depression, Anxiety, Osteoporosis, Mi-graine, Gastritis, Panic, Reduced Fertility, Palpitations, Diabetes, PMS, HiatusHernia, Tinnitus, Indigestion, Anaemia, Fatigue, Increased Heart Rate, RaisedBlood Pressure, Increased Stress, Irritable Bowel Syndrome, etc.

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5.4 Alternate OpinionAn article from a Mayo Clinic Psychiatrist, Daniel K Hall-Flavin, M.D. confirmsthat consumption of caffeine can make individuals susceptible to depression tohave worse effects of depression and loss of sleep. He also advises against abruptwithdrawal and suggests guided withdrawal of caffeine from the diet. However,he affirms that there is no research indicating a direct link between caffeineand depression. He goes on to propose in his series that B12 depletion anddepression are also correlated (90%) but not proven by research. It seems heis taking a politically correct stance in his statement. His article can be readonline. A web search using google or any other search engine on “Caffeine andDepression” may yield useful results.

DisclaimerThis information is from personal research owing to personal experience withcoffee and caffeine. For a thorough scientific analysis it is recommended thatyou consult your General Physician before taking any conclusions. I am noteducated as a Medical professional and hence cannot present this informationauthoritatively.

References1. Bruce M.S. et al (1989) Caffeine Abstension in the Management of Anxiety

Disorders, Psychol. Med. 19 pp 211 - 214, mentioned in Snaith P. (1991)Clinical Neurosis, 2nd edition, Oxford Medical Publications.

2. Conduit E. (1995) The Body under Stress, Lawrence Erlbaum Associates.

3. James J. (1997) Understanding Caffeine, Sage Publishers.

4. Keer D. et al, Ann. Internal. Med (1993) 119(8) pp 799 - 804, mentionedin Green Files, Vol 7, issue 4, December 1993.

5. McIntyre A. (1994) The Complete Womans Herbal, Gaia Publishers.

6. Murray M. (1995) Stress, Anxiety, and Insomnia, Prima Publishing.

7. O’Hara V. (1995) Wellness at Work, New Harbinger inc.

8. Snaith P. (1991) Clinical Neurosis, 2nd edition, Oxford University Press.

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