Chemistry Reference
In-Depth Information
bolus administration of caffeine that makes generalization to ordinary, daily-
dose patterns of use difficult. Some studies have stratified results by daily dose
level. For example, Rapoport et al (1981a) reported that high-dose consumers
($300 mg per day) were more easily frustrated, more nervous on tests, and less
able to distinguish between high and low doses of caffeine in acute
administration than were low-dose consumers (,50 mg per day). High-dose
consumers also suffered more apparent effects of withdrawal (Rapoport et al
1984). In children, tachycardia, vomiting, and diuresis are among the
commonly reported symptoms of high caffeine intake (Nawrot et al 2003),
but caffeine toxicity is rarely, if ever, fatal. One meta-analysis by Stein et al
(1996) showed that acute administration of caffeine did not result in
significantly negative effects in children. More recently, Meltzer et al (2008)
concluded that 0.3 mg kg
21
per day was the highest level of caffeine ingestion
at
d
n
0
t
2
n
g
|
3
which
no
immediate
adverse
effects
were
observed
in
children
and
adolescents.
In addition, it is known that caffeine has cardiac effects on adults, including
arrhythmias and increases in blood pressure. It is not evident, however,
whether these effects are similar, more pronounced, or even absent in children
and teens. In adults, arrhythmia and palpitations generally follow the
consumption of unusually large amounts of caffeine in healthy individuals
or result from chronic use in individuals with existing cardiac disorders
(Cannon et al 2001; Chopra and Morrison 1995; Curatolo and Robertson
1983). The effects of caffeine and cardiac effects in children have yet to be fully
investigated. This, combined with the fact that many children and adolescents
consume caffeine on a regular basis, suggests that the potential for cardiac
events as a function of caffeine consumption should be examined in the
pediatric population.
19.5 Sleep Effects
The effects of caffeine on sleep have been documented in a number of studies
although not on an experimental basis. Student surveys of middle and high
school students have suggested a link between caffeine consumption and sleep
reduction (Seicean et al 2007; Goldstein and Shapiro 1987). More recently,
Warzak et al (2011) reported the results of a parent survey of young children
5-12 years old, in which the relationship between caffeine consumption and
sleep was significantly negatively correlated. One study (Goldstein and Wallace
1997) suggested that consumption of as little as 50 mg per day could result in
higher wakefulness in children. The relationship between sleep and caffeine
becomes additionally confounded during puberty, as the circadian effects of
melatonin come to be at odds with the common sleep-wake cycle associated
with school attendance (Wolfson and Carskadon 2003).
Although insomnia and sleep difficulties have been mentioned as side effects
of caffeine in several pediatric studies (Bernstein et al 1994, 1998; Elkins et al
1981; Rapoport et al 1981a; 1981b; 1984), clear data on sleep disruption have
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