title: Sleep-disordered breathing and caffeine consumption: results of a community-based study.
abstract: BACKGROUND
  Sleepiness is one of the most burdensome symptoms of sleep-disordered breathing (SDB). While caffeine is frequently used to avert sleepiness, the association between SDB and caffeine use has not been thoroughly explored. The current study examined whether SDB is associated with caffeine consumption and if factors such as sex, age, and daytime sleepiness explain or modify the association.
  
  
  METHODS
  Data from the Sleep Heart Health Study, a community-based study on the consequences of SDB, were used to characterize the association between SDB and caffeine intake. SDB was assessed with full-montage polysomnography. Caffeine use was quantified as the number of cans of soda or the cups of coffee or tea consumed daily. The Epworth Sleepiness Scale was used to assess daytime sleepiness. Multivariable negative binomial regression models were used to characterize the independent association between SDB and caffeine use.
  
  
  RESULTS
  Caffeinated soda, but not tea or coffee, intake was independently associated with SDB severity. Compared with participants without SDB, the relative ratios for caffeinated soda consumption in women with mild, moderate, and severe SDB were 1.20 (CI, 1.03-1.41), 1.46 (CI, 1.14-1.87), and 1.73 (CI, 1.23-2.42), respectively. For men, an association was only noted with severe SDB and caffeinated soda use. Age did not modify the SDB-caffeine association, and sleepiness could not explain the observed associations.
  
  
  CONCLUSIONS
  SDB is independently associated with caffeinated soda use in the general community. Identifying excessive caffeine used in SDB has potential significance given the cardiovascular effects of caffeine and untreated SDB.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: R Nisha
authors.initials: RN
authors.lastname: Aurora
authors.affiliation: Department of Biostatistics, Johns Hopkins University, Baltimore, MD.
authors.forename: Ciprian
authors.initials: C
authors.lastname: Crainiceanu
authors.affiliation: Department of Biostatistics, Johns Hopkins University, Baltimore, MD.
authors.forename: Brian
authors.initials: B
authors.lastname: Caffo
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins University, Baltimore, MD. Electronic address: npunjabi@jhmi.edu.
authors.forename: Naresh M
authors.initials: NM
authors.lastname: Punjabi
mesh_terms: D000367:Age Factors; D000368:Aged; D002110:Caffeine / Q000009:adverse effects*; D002253:Carbonated Beverages / Q000009:adverse effects*; D003069:Coffee / Q000009:adverse effects; D003625:Data Collection; D004327:Drinking Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000503:physiopathology; D013662:Tea / Q000009:adverse effects
chemical_list: D003069:Coffee; D013662:Tea; D002110:Caffeine