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Study Title and Description

Adolescents living the 24/7 lifestyle: effects of caffeine and technology on sleep duration and daytime functioning.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on behavior*?
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Primary Publication Information
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TitleData
Title Adolescents living the 24/7 lifestyle: effects of caffeine and technology on sleep duration and daytime functioning.
Author CJ Calamaro,TB Mason,SJ Ratcliffe,
Country
Year 2009
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Behavior - Design Details - INCLUDED Studies
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 19482732
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What outcome is being evaluated in this paper? Behavior
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What is the objective of the study (as reported by the authors)? Adolescents may not receive the sleep they need. New media technology and new, popular energy drinks may be implicated in sleep deficits. In this pilot study we quantified nighttime technology use and caffeine consumption to determine effects on sleep duration and daytime behaviors in adolescents. We hypothesized that with increased technology use, adolescents increase caffeine consumption, resulting in insufficient sleep duration
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Inclusion criteria for this study were middle school and high school subjects aged 12 to 18 years who were patients in the pediatric practice at which the questionnaires were administered, were accompanied by caregivers, and were proficient in speaking and writing English. The Adolescent Sleep, Caffeine Intake, and Technology Use is a 36-item, 3-concept instrument developed by the investigators to measure adolescents’ intake of caffeinated drinks, use of nighttime media-related technology, and sleep behaviors. Items on the self-administered questionnaire include sleep and sleep-related behaviors, media related technology usage, sleep/wake cycle features, caffeine intake, and sleepiness and driving. Caffeine content of proprietary beverages was obtained from the manufacturers’ Web sites. Caffeine content for tea and coffee was obtained from the respective national associations. Estimated caffeine intake for tea refers to black tea; estimated caffeine intake for coffee refers to brewed coffee. Relationships between variables were first examined via correlation coefficients, t tests, and Fisher’s exact tests, as appropriate. Multiple regression techniques (linear or logistic) were then used to assess further the relationship between caffeine and technology use and sleep variables, having adjusted for age, race, gender, and BMI. All analyses were conducted by using SPSS 15.0 (SPSS Inc, Chicago, IL).
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Sleep
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes Specific endpoint was sleep duration
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Clinical
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Physiological Physiological
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Other
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What is the study design? Cross-sectional
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Subjective
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Optional: Name of Method or short description The Adolescent Sleep, Caffeine Intake, and Technology Use Questionnaire
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Caffeine (general)
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Coffee Coffee
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Chocolate
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Energy drinks Energy drinks
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Gum
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Medicine/Supplement
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Soda Soda
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Tea Tea
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Measured
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Self-report Self-report
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Children
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Adolescents Adolescents
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Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) Short vs long sleep duration
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) Multiple regression techniques (linear or logistic) were then used to assess further the relationship between caffeine and technology use and sleep variables, having adjusted for age, race, gender, and BMI. All analyses were conducted by using SPSS 15.0 (SPSS Inc, Chicago, IL).
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Provide a general description of results (as reported by the authors). Although caffeine consumption tended to be lower in the group of those who had 8 to 10 hours of sleep (medians: 8 –10 hours: 54.1 mg; 6 – 8 hours: 144.0 mg; 3–5 hours: 157.6 mg), this difference did not reach statistical significance (P .067).
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? With the availability of caffeinated drinks and sophisticated, portable, and personalized technology, our findings demonstrate that, despite the drive to sleep, adolescents use multiple forms of technology and consume caffeinated beverages to stay awake later into the night. Subsequently, their ability to stay alert and fully functional throughout the day was impaired by excessive daytime sleepiness.
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What were the sources of funding? This work was supported by National Heart, Lung, and Blood Institute grant 5-T32-HL07953– 03 (Allan Pack, MBChB, PhD, principal investigator).
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What conflicts of interest were reported? None reported
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Does the exposure (dose) need to be standardized to the SR? Yes
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest). Based on a median age of 15 (range = 12-18) a standard bw of 56.8 kg was used for conversion. 157.6 mg/56.8 kg = 2.77 mg/kg
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  Sleep duration NOAEL = 2.77 mg/kg
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. This NOAEL is the median caffeine consumption of specific low sleep duration group.
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What is the importance of the study with respect to the adverseness of the outcome? Important
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