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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #141

Tea Coffee Cup Drink Beverage  - yousafbhutta / Pixabay

Have patients that complain of a mid-morning or early afternoon crash? Do they drink caffeine containing products such as coffee first thing in the morning? Then educate them to wait about 2 hours after waking up to consume the caffeine.

Adenosine binds to the adenosine receptors in the central nervous system, which causes drowsiness by slowing down nerve activity. Adenosine can build up during the day, which will eventually cause you to be tired and will provoke the sensation of needing sleep. This in addition to the slow decline of cortisol can lead to sleepiness.

Caffeine is an adenosine receptor antagonist because it causes the adenosine receptors to no longer recognize adenosine at the receptor site, therefore the nerve activity speeds up.

For the majority of people, the hormone cortisol is the highest when you first wake up. Because cortisol levels are related to your level of wakefulness, it has been proposed that caffeine intake should be postponed until the cortisol levels begin to naturally decrease, which can be approximately 2 hours after you wake up.

If you drink caffeine at the peak of your morning cortisol level spike, then you are consuming the caffeine at the peak of natural alertness, which will create a tolerance in your body. Additionally, not only will you feel withdrawal from the caffeine, but you are also going to experience the drop in cortisol. What does this mean? A double PUNCH to your alertness and wakefulness.

Therefore, educate your patients NOT to consume caffeine during the first 2 hours of being awake. This will result in improved alertness during the day and will help prevent those “crashes” people experience. Consuming caffeine about 2 hours after awaking will help create sustained energy level to get through the day. I have personally started doing this, and it has been life changing!

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