Role of Excessive Caffeine in Triggering Bipolar Affective Disorder

Authors

  • Nida Saleem Department of Psychiatry, Armed Forces Institute of Mental Health /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Sohail Ali Department of Psychiatry, Armed Forces Institute of Mental Health /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Asif Azeem Department of Psychiatry, Armed Forces Institute of Mental Health /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Saleem Ullah Department of Psychiatry, Quetta Institute of Medical Sciences Quetta Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-2.12904

Keywords:

Bipolar disorder, Caffeine, Sleep, Trigger

Abstract

Objective: To analyze the impact of excessive caffeine consumption, causing sleep disturbance and consequent triggering of the onset or relapse among patients with bipolar affective disorder.

Study Design: Analytical cross-sectional study.

Place and Duration of study: Armed Forces Institute of Mental Health (AFIMH), Rawalpindi, Pakistan, from Nov 2021 to Apr 2022.

Methodology: A total of 110 patients, aged 20-60 years and diagnosed with bipolar affective disorder, were evaluated for triggering effect on disease after excessive caffeine intake of at least 180mg/day, in the last 2 weeks, along with effect of other triggering factors with or without caffeine. All data was analysed using SPSS.

Results: A total of 69% of patient’s disease was triggered due to excessive caffeine alone and combined with factors of stress and non-adherence. Based on scores using Athens insomnia rating scale, 99% of our patients fulfilled the criteria for sleep disturbance.

Conclusion: Excessive caffeine use significantly impairs sleep and thus contribute to onset or relapse of symptoms in patients with bipolar affective disorder.

Downloads

Download data is not yet available.

References

1. Frigerio S, Strawbridge R, Young AH. The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review. Bipolar Disord 2021; 23(3): 241-251.

https://doi.org/10.1111/bdi.12990

2. Abdoli F, Davoudi M, Momeni F, Djafari F, Dolatshahi B, Hosseinzadeh S et al. Estimate the prevalence of daily caffeine consumption, caffeine use disorder, caffeine withdrawal and perceived harm in Iran: a cross-sectional study. Sci Rep 2024; 14(1): 7644.

https://doi.org/10.1038/s41598-024-58496-8

3. Aleem A, Amanullah I, Ali MA, Ghumman MHM, Tahir I, Tahir R et al. Association of Depression and Anxiety with Consumption of Caffeine-Containing Beverages in University Students of Lahore, Pakistan. J Health Rehabil Res 2024; 4(3).

https://doi.org/10.61919/jhrr.v4i3.1256

4. Mannix D, Mulholland K, Byrne F. Caffeine-Induced Psychosis: A Case Report and Review of Literature. Cureus 2024; 16(8): e66306.

https://doi.org/10.7759/cureus.66306

5. Meredith SE, Juliano LM, Hughes JR, Griffiths RR . Caffeine Use Disorder: A Comprehensive Review and Research Agenda. J Caffeine Res 2013; 3(3): 114-130.

https://doi.org/10.1089/jcr.2013.0016

6. Abaatyo J, Kaggwa MM, Favina A, Olagunju AT. Readmission and associated clinical factors among individuals admitted with bipolar affective disorder at a psychiatry facility in Uganda. BMC Psychiatry 2023; 23(1): 474.

https://doi.org/10.1186/s12888-023-04960-0

7. Kiselev BM, Shebak SS, Milam TR. Manic Episode Following Ingestion of Caffeine Pills: A Case Report. Prim Care Companion CNS Disord 2015; 17(3): 10.4088/PCC.

https://doi.org/10.4088/pcc.14l01764

8. Mercader C, Patel BP. Caffeine abuse: the phantom differential in sleep complaints/disorders? J Substance Use 2013; 18(3): 242–245.

9. Gross G, Maruani J, Vorspan F, Benard V, Benizri C, Brochard H et al. Association between coffee, tobacco, and alcohol daily consumption and sleep/wake cycle: an actigraphy study in euthymic patients with bipolar disorders. Chronobiol Int 2020; 37(5): 712–722.

https://doi.org/10.1080/07420528.2020.1725542

10. Gupta R, Neubauer DN, Pandi Perumal SR. Sleep and Neuropsychiatric Disorders. Springer, Singapore 2022: 845. https://doi.org/10.1007/978-981-16-01

11. Cardinale R, Donnell L, Chun J, Park K, Kross E, Kamali M, et al. A Preliminary Study of Central Nervous System Arousal and Sleep Quality in Bipolar Disorder. Psychopathology 2018; 51 (4): 269–275.

https://doi.org/10.1159/000489679

12. Sameer HM, Imran N, Tarar TN, Khawaja IS. Association of Excessive Daytime Sleepiness with Psychological Distress in Medical Students. Prim Care Companion CNS Disord 2020; 22(1): 19m02531.

https://doi.org/10.4088/pcc.19m02531

13. Maqsood U, Zahra R, Latif MZ, Athar H, Shaikh GM, Hassan SB. Caffeine Consumption & Perception of Its Effects Amongst University Students. Proceedings 2021; 34(4): 46–51.

https://doi.org/10.47489/p000s344z770mc

14. Tahir D, Rehman I, Zahra T. Assessing the correlation between caffeine consumption and its effect on academic performance of medical students of Shifa College of Medicine Islamabad, Pakistan. A Cross- sectional Study. J Rawalpindi Med Coll 2022; 26(1): 5-10.

https://doi.org/10.37939/jrmc.v26i1.1559

15. Ahmad M, Hinna RE, Ahmad . Knowledge and trends of caffeine consumption Among medical and non-medical students of Lahore Pakistan. Pak J Neurol Sci 2017; 12(2): 5.

16. Morgan C, Ashcroft DM, Graham CAC, Sperrin M, Webb RT, Francis A, et al. Identifying prior signals of bipolar disorder using primary care electronic health records: a nested case–control study. Br J Gen Pract 2024; 74 (740): e165-e173.

https://doi.org/10.3399/bjgp.2022.0286

17. Sharma P, Shivhare P, Marimutthu P, Sharma MK, Murthy P. Patterns of Caffeine Use and Validation of Assessment in Psychiatric Population: An Implication in Primary Care Setting. J Family Med Prim Care 2020; 9(10): 5252-5255.

https://doi.org/10.4103/jfmpc.jfmpc_698_20

18. Kunitake Y, Mizoguchi Y, Sogawa R, Matsushima J, Kato TA, Kawashima T et al. Effect of Excessive Coffee Consumption on the Clinical Course of a Patient with Bipolar Disorder: A Case Report and Literature Review. Clin Neuropharmacol 2017; 40(4): 160-162.

https://doi.org/10.1097/wnf.0000000000000222

Downloads

Published

31-03-2026

Issue

Section

Original Articles

Categories

How to Cite

1.
Saleem N, Ali S, Azeem A, Ullah S. Role of Excessive Caffeine in Triggering Bipolar Affective Disorder. Pak Armed Forces Med J [Internet]. 2026 Mar. 31 [cited 2026 Apr. 5];76(SUPPL-2):S473-S477. Available from: https://www.pafmj.org/PAFMJ/article/view/12904