title: Caffeine Awareness in Children: Insights from a Pilot Study.
abstract: OBJECTIVE
  Caffeine, a commonly consumed psychoactive substance, can have significant effects on sleep. Caffeine intake among children is increasing, mainly in the form of sodas. However, adolescent caffeine consumers may lack knowledge about the caffeine content in common beverages. If true, this very fact may hamper the assessment of the effects of caffeine consumption on sleep in children if such assessments are a priori dependent on responders being able to reliably distinguish between caffeinated and noncaffeinated beverages. This preliminary study investigated adolescents' caffeine knowledge and intake at a Cleveland-area public middle school.
  
  
  METHODS
  Seventh- and eighth-grade students were surveyed using: (1) the Caffeine Literacy and Sleep Study (CLASS), a 15-question pilot instrument designed to assess caffeine knowledge and intake by type, quantity and timing, as well as sleep habits; and (2) the Cleveland Adolescent Sleepiness Questionnaire (CASQ), a validated survey measuring excessive daytime sleepiness in adolescents. These questionnaires were distributed and collected during a specified class period.
  
  
  RESULTS
  Of the 635 seventh- and eighth-grade students who attended school on the day of the study, 555 (87%) participated. Lack of knowledge about caffeine content of particular drinks was noted in seventh and eighth graders of both sexes with nearly 29% unaware that their favorite drinks contain caffeine and more than 50% unable to correctly identify the drinks with the most caffeine. A low percentage of students correctly identified light-colored sodas lacking caffeine: 7-Up (24.1%), Sierra Mist (38.9%), ginger ale (39.8%), Sprite (39.8%), and Fresca (53.7%). The percentages of students correctly identifying caffeinated light-colored beverages were: Arizona Green Tea (43.5%), Mello Yellow (50.9%), and A&W cream soda (67.6%). However, Mountain Dew was correctly identified by most (93.5%) as caffeinated.
  
  
  CONCLUSIONS
  Students were not consistently able to identify caffeine content or lack thereof in some common beverages. The results of this pilot study show that caffeine literacy in adolescents warrants further investigation and educational intervention.
authors.affiliation: Lata Medical Research Foundation, Nagpur, India.|Virginia Commonwealth University Department of Psychiatry, Richmond, VA.|Comprehensive Sleep Care Center, Lansdowne, VA.
authors.forename: Tushar P
authors.initials: TP
authors.lastname: Thakre
authors.affiliation: Cleveland Clinic Sleep Disorders Center, Cleveland, OH.
authors.forename: Ketan
authors.initials: K
authors.lastname: Deoras
authors.affiliation: Saint Agnes Hospital, Baltimore, MD.
authors.forename: Catherine
authors.initials: C
authors.lastname: Griffin
authors.affiliation: The Pediatric and Adolescent Sleep Center, Fairfax, VA.
authors.forename: Aarthi
authors.initials: A
authors.lastname: Vemana
authors.affiliation: Cleveland Clinic Sleep Disorders Center, Cleveland, OH.
authors.forename: Petra
authors.initials: P
authors.lastname: Podmore
authors.affiliation: Akron Children's Hospital, Akron, Ohio.|Northeast Ohio Medical University (NEOMED), Rootstown, OH.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Krishna
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001364:Awareness; D001628:Beverages / Q000009:adverse effects* / Q000706:statistics & numerical data; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D020380:Needs Assessment; D010865:Pilot Projects; D018570:Risk Assessment; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000453:epidemiology; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D002110:Caffeine
keywords: adolescents; caffeine; sleep
references.citation: J Youth Adolesc. 2013 Jul;42(7):1053-62
references.pmid: 23358888
references.citation: Food Chem Toxicol. 2002 Sep;40(9):1231-4
references.pmid: 12204386
references.citation: Sleep. 2002 Sep 15;25(6):606-14
references.pmid: 12224839
references.citation: Pediatrics. 2003 Jan;111(1):42-6
references.pmid: 12509552
references.citation: J Am Diet Assoc. 2003 Oct;103(10):1326-31
references.pmid: 14520252
references.citation: J Pediatr Health Care. 2004 May-Jun;18(3):130-7
references.pmid: 15129213
references.citation: Prog Clin Biol Res. 1984;158:185-213
references.pmid: 6396645
references.citation: Pediatrician. 1990;17(1):5-12
references.pmid: 2315238
references.citation: J Clin Pharmacol. 1997 Aug;37(8):693-703
references.pmid: 9378841
references.citation: Exp Clin Psychopharmacol. 1998 Feb;6(1):87-95
references.pmid: 9526149
references.citation: Neurosci Biobehav Rev. 1999 Mar;23(4):563-76
references.pmid: 10073894
references.citation: J Am Diet Assoc. 2005 Jan;105(1):110-3
references.pmid: 15635355
references.citation: Crit Rev Food Sci Nutr. 2005;45(7-8):535-62
references.pmid: 16371327
references.citation: J Adolesc Health. 2006 Apr;38(4):451-3
references.pmid: 16549311
references.citation: J Clin Sleep Med. 2007 Oct 15;3(6):603-12
references.pmid: 17993042
references.citation: J Food Sci. 2007 Aug;72(6):C337-42
references.pmid: 17995675
references.citation: Sleep Med Rev. 2008 Apr;12(2):153-62
references.pmid: 17950009
references.citation: Neurosci Biobehav Rev. 2009 Jun;33(6):793-806
references.pmid: 19428492
references.citation: Pediatrics. 2009 Jun;123(6):e1005-10
references.pmid: 19482732
references.citation: Health Educ Behav. 2010 Jun;37(3):330-42
references.pmid: 19858312
references.citation: Exp Clin Psychopharmacol. 2010 Dec;18(6):510-20
references.pmid: 21186925
references.citation: J Pediatr. 2011 Mar;158(3):508-9
references.pmid: 21167501