Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Don’t use stimulants to cram for exams. It ruins sleep and doesn’t help test scores.

Sara C. Mednick, PhD
Meds
October 26, 2019
14 Shares
Share
Tweet
Share

Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you “awesome at everything.” Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat.

Welcome to #GenerationAdderall, the kids who grew up in the years of the diagnosis boom of attention deficit/hyperactivity disorder. As such, their formative years during this period normalized the habit and granted easy access to stimulants traditionally used to treat children with the diagnosis.

Nonprescription use of stimulants is a growing problem for young people, bringing not only a risk of overdose and addiction but also damage to sleep.

Between 2008 and 2012, nonmedical use of stimulants in 18- to 25-year-olds increased from 5.7% to 9.3%. The last two decades saw a 10-fold increase. While college-age adults show the greatest prevalence, up to 20% of those 12 and up report experience with nonmedical use of prescription drugs, indicating that the diversion of these medications for nonmedical use begins in middle and high school.

I study the important role of sleep for brain functioning and health. My work has introduced napping as a fatigue countermeasure and a powerful vehicle to boost long-term memory, creativity, executive function and restorative processes. Given the escalating campus crisis of stimulant use and damage to sleep, recent work in my lab has studied nonmedical use of stimulants in healthy young adults, and demonstrated that they’re not getting the academic edge they want, and they could be harming themselves.

A cocktail of substances leads to complications

Misusing prescription stimulants does not occur in a bubble. Compared with medical users and nonusers, adolescents who report nonmedical use of prescription drugs also engage in binge drinking more often. They also have lower academic attainment and a higher likelihood to screen positive for other substance abuse.

This is deeply troubling to those of us who study drugs’ various effects on the brain and body. Co-ingestion of prescription drugs and alcohol is linked to higher blood alcohol concentrations that cause fatal overdoses, increased risk for liver and heart damage, impaired driving and traffic accidents. Indeed, emergency room visits due to nonmedical use of stimulants tripled from 5,212 visits in 2005 to 15,585 visits in 2017, due to negative side effects including nervousness, insomnia, dizziness, and cardiovascular or psychiatric problems.

Unlike opioids, the motivation to misuse stimulants is not to check out, but rather to check in at superhero scale. Nonmedical stimulant use is primarily to increase wakefulness, having been used for decades by individuals whose job description includes sleep disruption. For emergency workers, military and shift workers, long periods without sleep can cause life-threatening lapses in attention. But these extreme scenarios bear little resemblance to the desired benefits by college students, who report popping pills “to improve intellectual performance” or to “party longer and drink more.”

Given these differences, a critical question is whether stimulants actually produce cognitive enhancement in healthy, well-rested people. Surprisingly, the answer is: sometimes, and only a little.

More hype than help

During the two to four hours that the drug is active, some studies in healthy, well-rested adults have shown short-term increases in attention and working memory. Some, however, have shown no benefit.

In fact, some studies suggest that stimulants may simply serve to make boring tasks more interesting by acting on the dopamine system. This extra-ordinary excitement allows students to stick with a particularly arduous assignment for longer periods of time than they normally would, which may promote the feeling of being smarter, as well as increasing the potential for addiction.

The question then becomes: Does the cognitive enhancement of stimulants exceed the significant long-term toll on sleep and the cognitive and health processes that rely on sleep?

Research in my lab has shown that there are significant trade-offs of long-term sleeplessness for this small uptick in attention. We show that even a morning dose – or at 9 a.m. – harms nighttime sleep. This is particularly true for deep sleep, which is important for complex thinking, long-term memory, immune function and physical restoration.

Additionally, stimulants reduce performance improvements on cognitive tasks that overnight sleep confers, such as improvement in working memory and long-term memory. This reduction is directly related to the decrease in deep sleep. Therefore, even when stimulants are taken earlier in the day, they disrupt nighttime sleep and subsequent cognitive performance.

So, is the fleeting benefit from stimulants worth the damage to sleep and long-term cognitive and health processes? Is the risk of increased substance abuse that comes with misuse of stimulants tolerable? Is it easier to be a superhero by taking a pill to stay awake and a pill to go to sleep than to simply get enough sleep?

Many students will likely be faced with these questions at college this year. As university leaders, counselors, parents, teachers, coaches and peers, it’s our job to help them make an informed decision.

As a sleep expert and cognitive neuroscientist, I think the answer to all these questions is: No.

Sara C. Mednick is an associate professor of cognitive science, University of California, Irvine. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Image credit: Shutterstock.com 

Prev

All the wellness in the world won’t help physician burnout

October 26, 2019 Kevin 5
…
Next

When we walk into a patient's room, we are entering a story

October 27, 2019 Kevin 1
…

Tagged as: Medications, Psychiatry

Post navigation

< Previous Post
All the wellness in the world won’t help physician burnout
Next Post >
When we walk into a patient's room, we are entering a story

Related Posts

  • Sleep and the medical profession have an uneasy relationship

    Yoo Jung Kim, MD
  • Medical school and the science of sleep

    Sarah Murad
  • Board reviews: How institutions can help students and residents pass their exams

    Sheryl Ramer
  • a desk with keyboard and ipad with the kevinmd logo

    The impact of removing numerical scores from USMLE Step 1

    Cory Michael, MD
  • Second-tier, off-label treatments for anxiety

    Wallace B. Mendelson, MD
  • Please don’t ask about my test scores, Mom

    Casey Paul Schukow

More in Meds

  • The real cause of America’s opioid crisis: Doctors are not to blame

    Richard A. Lawhern, PhD
  • Can personalized medicine live up to its hype in health care?

    Ketan Desai, MD, PhD
  • The effects of the nationwide stimulant shortage on a private psychiatry practice

    Christine Tran-Boynes, DO
  • Why North American medical cannabis can’t compete globally

    Michael Sassano
  • How were we duped and what can we do about the opioid overdose crisis?

    Ronald A. Zent, MD
  • Caught in the middle: How health insurance companies influence cancer drug selection

    Paul Pender, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • How Did Pulse Oximeters Perform in Black Kids?
  • Coffee and Heart Function; Ionizing Radiation and CVD
  • Health Inequity Should Be Labeled as a 'Never Event'
  • Healing the Damaged Nurse-Physician Dynamic
  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...