Caffeine, Migraine and disordered sleep - cumulative effects and Little Red Riding Hood

[Ellen S]

Do you know what caffeine actually does inside your body? inside your brain?

You know that it helps you to stay awake, but did you know that the effects inside your brain is actually cumulative? Those with sleep trouble and Migraine are especially at risk.

My analogy is the children's tale of Little Red Riding Hood - Adorable little red-caped girl skips thru the woods to visit dear old grandma, only to find that a nasty, hungry wolf has beat her there. The wolf dresses in grandma's clothes and fools the girl in attempt to eat her up. In comes the woodsman who saves said adorable girl from certain death. My story however, has a twist...



Getting to know the characters

In our analogy, the cute little red-caped girl's real name is Adenosine. Okay, in reality, adenosine is a chemical that is made in the brain, whose job is to slow down neuronal activity. It makes us sleepy so our brains are sure to have the chance to recharge. Adenosine levels increase when we are awake, and decrease when we are asleep. The more active our brains are, the more adenosine is created as a sort of check system so we don't overdo. It also causes blood vessels inside the brain to dilate - perhaps to allow good oxygen saturation in the brain during sleep. When researchers block adenosine in the brain they create an alert state. When they gave injections of adenosine it created normal sleep. Adenosine is also an important part of adenosine triphosphate, or ATP, the energy-storage molecule that powers most of the biochemical reactions inside the mitochondria of your cells. Adenosine's effects aren't entirely good however, and include potentially harmful actions such as lowered body temperature, altering blood pressure and damaging the heart.

Grandma's house is the adenosine receptor. In real life, this is a special place (like a lock) where adenosine molecules (special keys) fit precisely to create the reaction that slows the neuronal firing.

Caffeine is the big, bad wolf. The poor adenosine receptor can't tell the difference between the cute little girl (adenosine) and the wolf (caffeine), so when the wolf comes to the door Grandma lets him in. Oh No! When the wolf gets in the house chaos breaks out.

In our analogy, the wolf does some pretty nasty things like eating grandma and putting on her nightgown (which is the brain chemical Dopamine). Like a nice, soft, warm nightgown, dopamine is the 'feel good' chemical in your brain. Altered dopamine levels play a part in addiction, movement disorders, and depression. In reality, caffeine attaches to the adenosine receptor, but instead of singing a lullaby to quiet the brain, it does the opposite. Great excitement is created instead and the brain begins to hyper-react and neurons fire fast and furious.

Somebody in the neighborhood (pituitary gland) panics when they witness the mayhem, and assumes there is an emergency occurring and he might die, so it sends out the Woodsman (fight or flight hormone called adrenaline) to prepare to save the neighborhood from sure disaster.

When the powerful woodsman (adrenaline) is unleashed, he goes a little nuts in his mis-guided attempts to save everyone from imminent disaster. This is how caffeine causes the 'boost' feeling. Adrenaline dilates your pupils so you will be hyper-vigilant. He opens your airways so you can run farther and faster (this is why those with asthma and allergic reactions are given adrenaline in an emergency). You breathe more shallow. Adrenaline makes your heart beat faster and harder, and constricts blood vessels away from your extremities (fingers, toes) to flight organs. He makes your liver release sugar for extra energy, and tightens your muscles so they are ready and instantly warm to run away or fight for your life. Adrenaline can slow or halt labor in pregnant animals. The woodsman shuts down your digestive system so energy is concentrated in the areas of your body that will keep you safe - digestion can be done later when there is time. (This is why prey animals have very small stomachs and more complicated digestive tracts)

Most people consume caffeine throughout the day, resulting in high levels of the drug during the night. The brain won't properly sleep because adenosine isn't able to sit comfortably in the receptors, turn the lock and induce it. When you finally go to sleep, there is still insufficient adenosine in the receptors to create a restful sleep. Your woodsman is still out trying to slay the wolf, even in the middle of the night. Eventually the caffeine leaves your system, but not soon enough for the brain to recharge. This leads to fatigue, and a need for another dose of caffeine to function. It doesn't take a lot of imagination to understand the physical stress wreaked on the body when it goes day in and day out, preparing for a disaster of potential life-ending proportions. We used to think that eventually the adenosine system learned to compensate for this...

Now, here's the twist to the story:

For years, scientists thought the cumulative effects of caffeine were limited to the description above. A new brain imaging study by Wake Forest University in North Carolina shows that chronic consumption of high amounts of caffeine actually results in changes within the brain itself, and diminished blood flow capacity for which the brain cannot fully compensate. Dr Daniel Amen, MD - a leading expert in brain imaging - states,

"I can assure you that reduced cerebral blood flow leads to brain drain. It lowers cognitive function and can exacerbate emotional and mental health problems. It can also wreak havoc with your sleep system and reduce the amount of deep sleep you get at night, leaving you feeling even more fatigued."

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Caffeine is legal, but it is no less a powerful drug than many prescriptions. Also considered a food additive, the chemical is thrown at us in so many foods and drinks that those who choose to abstain from it find themselves reading nearly every label available in the effort to keep it at arm's length.

For those active in the sleep community, caffeine's direct activity on the CNS and suppression of drowsiness is famous. I'm wondering how many Health Activists have read the Wakefield study and are aware that the effects go beyond simple sleep deprivation? How many in your sleep communities abstain completely from caffeine consumption in effort to regain healthy sleep patterns again?

While Migraineurs sometimes find that caffeine helps relieve the pain of an attack (hence their inclusion in many Migraine medicines), they are often unaware that caffeine frequently causes rebound headaches which may occur hours or days after the initial attack. Additionally, the sleep disruption caused by its use can trigger Migraine in many individuals. For Migraine leaders, I'm curious how many of you encourage complete abstainance from caffeine containing products? How receptive are your communities to quitting their daily caffeine 'fix'? Do you use caffeine for a 'java jolt' or as an adjunctive treatment for Migraine attacks?

For additional reading:

Science of sleep
Cause of insomnia

Migraine trigger
Migraine medication

Join in the discussion:

Sleep and the adenosine/caffeine connection
Migraine, and the adenosine/caffeine connection
Health vices - how bad are they?
Another reason to drink some coffee
Why am I up all night?
Sleep - people aren't doing it anymore