Caffeinated Gum for Sleep Deprivation

Recruiting in Palo Alto (17 mi)

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Walter Reed Army Institute of Research (WRAIR)

Trial Summary

What is the purpose of this trial?While the negative impact of sleep deprivation on cognitive processing and the partial reversal of this phenomenon by caffeine are well known, the types of cognitive processing previously studied have been limited to simple, straight-forward laboratory tasks. It is unclear how sleep deprivation and caffeine affect performance on operationally relevant complex cognitive tasks, like those encountered by working professionals such as doctors. This study aims to uncover how sleep deprivation and caffeine impact two types of clinical reasoning processes encountered by physicians on a daily basis. Previous work from members of our team investigated diagnostic reasoning in medical professionals and discovered that brain activation in executive processing areas was modulated by self-reported sleepiness and burnout and level of expertise (Durning, Costanzo, et al., 2013; Durning et al., 2014, 2015). The current study aims to expand upon those findings by also investigating a potentially more complex type of clinical reasoning, i.e. therapeutic reasoning, and directly manipulating sleep and caffeine use in a controlled sleep laboratory. Medical students, residents, and board-certified physicians will undergo thirty-seven hours of sleep deprivation and ten hours of sleep recovery in the sleep laboratory. During two FMRI scan sessions we will present high-quality validated multiple-choice questions on common patient situations in internal medicine to participants to explore brain activity during therapeutic reasoning compared with diagnostic reasoning. One FMRI scan will occur following a night of sleep deprivation, and another scan will occur following a night of recovery sleep. Additionally, half of the participants will receive caffeine gum during the sleep deprivation period, while the other half will receive placebo gum. This design will allow us to study the effect of sleep deprivation and caffeine on the neural correlates of diagnostic and therapeutic reasoning and performance in general.

Eligibility Criteria

This trial is for medical students, residents, and board-certified internists in the National Capital Area who sleep 6-9 hours nightly. Excluded are those with certain health conditions like high blood pressure or obesity, heavy caffeine or alcohol users, smokers, drug users, and people with a history of psychiatric disorders.

Inclusion Criteria

Novice group - National Capital Area Interns and Medical Students (3rd and 4th year only)

Expert group - Board certified internists from National Capital Area

Intermediate group - National Capital Area PGY-2 and 3 residents in internal medicine

Exclusion Criteria

You have a high level of anxiety, scoring 41 or higher on a specific anxiety test.

I have a history of a neurological disorder.

Active duty military or federal personnel not off duty and not on approved annual leave for the enrollment visit as well as the in-laboratory phase of the study

+29 more

Participant Groups

The study tests how sleep deprivation affects complex cognitive tasks in medical professionals by comparing brain activity during diagnostic and therapeutic reasoning after sleep loss versus recovery sleep. Participants will be deprived of sleep for 37 hours followed by recovery rest. Half will chew Military Energy Gum containing caffeine; the other half placebo gum.

2Treatment groups

Active Control

Placebo Group

Group I: Caffeine GroupActive Control1 Intervention

This group will receive caffeine gum.

Group II: PlaceboPlacebo Group1 Intervention

This group will receive gum without caffeine.