Comparison of Caffeine and Nicotine on Sleep Quality of Male Medical Students of Quaid-e-Azam Medical College, Bahawalpur
DOI:
https://doi.org/10.47489/szmc.v40i2.824Keywords:
Caffeine, Nicotine, male medical students, Pittsburgh sleep quality indexAbstract
Background: Caffeine and nicotine are two commonly used substances among medical student to combat fatigue and improve alertness. However both substances have been associated with reduced sleep duration and increased sleep latency. Comparative studies evaluating their effects on sleep quality among medical students are scarce.
Objective: To assess the prevalence of caffeine and nicotine use among male medical students of Quaid-e-Azam and to evaluate their comparative effects on sleep quality of the students.
Method: This cross-sectional study was conducted in the Department of Pharmacology, QAMC. A total of 200 male MBBS students aged 18–25 years were recruited. Participants were classified into caffeine users (n = 110), nicotine users (n = 50), and non-consumers (n = 40). Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Data were analyzed by one-way ANOVA followed by Tukey’s HSD post hoc test using SPSS version 25. A p-value < 0.05 was considered statistically significant.
Results: Overall, 120 students (60%) reported poor sleep quality (PSQI > 5). Poor sleep was most frequent among nicotine users (74%), followed by caffeine users (62.7%), and non-consumers (35%). Nicotine users had the shortest mean sleep duration (5.4 ± 1.2 hours) and longest sleep latency (34 ± 11 minutes) compared to caffeine users (5.9 ± 1.4 hours; 28 ± 9 minutes) and non-consumers (6.8 ± 1.1 hours; 18 ± 6 minutes). Intergroup comparisons showed nicotine had significantly greater effects statistically on both sleep duration and latency as compared to caffeine(p < 0.001).
Conclusion: Both caffeine and nicotine negatively affect sleep quality among male medical students, with nicotine leading a more pronounced effect by reducing sleep duration and increasing sleep latency.
References
Baranwal N, Phoebe KY, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Prog cardiovasc dis. 2023 Mar 1;77:59-69. doi.org/10.1016/j.pcad.2023.02.005
Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SM,et al The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health. 2023 Dec 1;9(6):801-20. doi.org/10.1016/j.sleh.2023.07.016
Perotta B, Arantes-Costa FM, Enns SC, Figueiro-Filho EA, Paro H, Santos IS, et al. Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students. BMC medical educ. 2021 Feb 17;21(1):111-23. doi.org/10.1186/s12909-021-02544-8
Baldassarri SR, Chu JH, Deng A, Xu Z, Blohowiak RF, Byrne S, et al. Nicotine, alcohol, and caffeine use among individuals with untreated obstructive sleep apnea. Sleep Breath. 2023 Dec;27(6):2479-90. doi.org/10.1007/s11325-023-02830-3.
Faudone G, Arifi S, Merk D. The medicinal chemistry of caffeine. J Med Chem. 2021 May 21;64(11):7156-78. doi.org/10.1021/acs.jmedchem.1c00261
Raju A, Chandran M, Fredrick J. Excessive day time sleepiness, poor sleep quality, and their association to caffeine consumption among young Informational Technology professionals. Ind Psychiatry J. 2025 May 1;34(2):191-5. doi: 10.4103/ipj.ipj_247_24
Carstens E, Carstens MI. Sensory effects of nicotine and tobacco. Nicotine Tob Res. 2022 Feb 14;24(3):306-15. doi:10.1093/ntr/ntab086
Nuñez A, Rhee JU, Haynes P, Chakravorty S, Patterson F, Killgore WD, et al. Smoke at night and sleep worse? The associations between cigarette smoking with insomnia severity and sleep duration. Sleep Health. 2021 Apr 1;7(2):177-82. doi.org/10.1016/j.sleh.2020.10.006
Alshumrani R, Shalabi B, Sultan A, Wazira L, Almutiri S, Sharkar A. Consumption of energy drinks and their effects on sleep quality among medical students. J Fam Med Prim Care. 2023 Aug 1;12(8):1609-14. DOI: 10.4103/jfmpc.jfmpc_1_23.
Nabhan EM, Jaafar K, Daoud R, Nasser Z, Daoud Jr R. Sleep quality and nicotine dependence among Lebanese university residents and fellows: a cross-sectional study. Cureus. 2023 Jul 24;15(7):1-11. doi: 10.7759/cureus.42364
Le Foll B, Piper ME, Fowler CD, Tonstad S, Bierut L, Lu L,et al. Tobacco and nicotine use. Nat Rev Dis Prim. 2022 Mar 24;8(1):19. doi.org/10.1038/s41572-022-00346-w
Yadav M. Diet, sleep and exercise: the keystones of healthy lifestyle for medical students. J Nepal Med Assoc. 2022 Sep 30;60(253):841-43. doi: 10.31729/jnma.7355
Gupta R, Taneja N, Anand T, Gupta A, Gupta R, Jha D, et al, sleep quality and depressive symptoms amongst medical students in Delhi, India. Community Ment. Health J. 2021 May;57(4):771-6. doi:10.1007/s10597-020-00697-2
Zitser J, Allen IE, Falgàs N, Le MM, Neylan TC, Kramer JH, et al. Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. PloS one. 2022 Jun 24;17(6):e0270095-04. doi.org/10.1371/journal.pone.0270095
Zhang X, Dai X, Jiao J, Lee SY. Impact of sleep-wake features on fatigue among female shift work nurses. Anna Med. 2023 Dec 12;55(1):2210843-50. doi.org/10.1080/07853890.2023.2210843
El Hashem A, Bou Saba A, Bou Madi AM, Mahfouz C, Derian C, El Husseiny E, et al. Patterns and prevalence of depression, tobacco, and caffeine use among university students from different majors in Lebanon: a cross-sectional study. Front Public Health. 2025 Jun 4;13:1605086-96. doi.org/10.3389/fpubh.2025.1605086
Leger D, Andler R, Richard JB, Nguyen?Thanh V, Collin O, Chennaoui M, Metlaine A. Sleep, substance misuse and addictions: a nationwide observational survey on smoking, alcohol, cannabis and sleep in 12,637 adults. J sleep res. 2022 Oct;31(5):e13553. doi.org/10.1111/jsr.13553
Akova ?, Duman EN, Sahar AE, Sümer EH. The relationship between caffeine consumption and depression, anxiety, stress level and sleep quality in medical students. Turk J Sleep Med. 2023 Feb 10(1);65-70. doi:10.427/jtsm.galenos.2022.06078
Ali A, Albahrani A, Alnasser A, Alsalman A, Alaithan M, Alswaidan M, et al. The effect of caffeine on sleep among medical students at king Faisal University Saudi Arabia. Middle East J Fam Med. 2021 Jun 1;7(10):51-58.doi: 10.5742/MEWFM.2021.94065
Vera V, Oñate G, Fernández M, Valladares M, Crovetto M, Espinoza V,et al. Tobacco consumption in Chilean university students and associations with anthropometry, eating habits and sleep quality multicentric study.J Prev Med Hyg. 2021 Jul 30;62(2):E430–E438. doi: 10.15167/2421-4248/jpmh2021.62.2.1868
Singh N, Wanjari A, Sinha AH. Effects of nicotine on the central nervous system and sleep quality in relation to other stimulants: a narrative review. Cureus. 2023 Nov 21;15(11) 1-9. doi:10.7759/cureus.49162
Spadola CE, Guo N, Johnson DA, Sofer T, Bertisch SM, Jackson CL, et al. Evening intake of alcohol, caffeine, and nicotine: night-to-night associations with sleep duration and continuity among African Americans in the Jackson Heart Sleep Study. Sleep. 2019 Nov;42(11):zsz136-42. doi.org/10.1093/sleep/zsz136
Meneo D, Bacaro V, Curati S, Russo PM, Martoni M, Gelfo F, et al. A systematic review and meta-analysis of the association between young adults’ sleep habits and substance use, with a focus on self-medication behaviours. Sleep Med Rev. 2023 Aug 1;70:101792.doi.org/10.1016/j.smrv.2023.101792
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