Each morning I unwrap a small sack of coffee beans, pour them carefully into a grinder, fasten the lid, and let the whir of the grinder wake me up. Making coffee has become essential to my morning routine. I genuinely like it, but sometimes I need it. Modern attitudes surrounding caffeine consumption align with the second sentiment, highlighted by the “but first, coffee” movement.

It seems harmless enough, but could the pro-caffeine lifestyle be exacerbating a growing epidemic of sleep deprivation?

The first Starbucks opened in 1971. By 1985, they Starbucks Corporation became publically traded. By 1994 they had grown to 300 locations and they now have more than 30,000 locations worldwide (more than 15,000 in the U.S. alone). The company’s market value has risen to more than $70 billion and, of course, they are not the sole purveyor of coffee.

The energy drink industry, brought to prominence by Red Bull in 1997, has also been growing. The market is more than $50 billion and there has been notable increase in consumption, especially among adults. A recent study found that adult consumption of energy drinks was ten times higher in 2016 than its 2003 (5.5% of the population, up from 0.5%) and is projected to rise in coming years.

Caffeine consumption is directly tied to poor sleep quality. Brewed coffee has, on average, 96g of caffeine per serving. Some energy drink are three times as potent.

Americans have been sleeping fewer and fewer hours per night over recent years, down one full hour since the 1940s, to a measly 6.8 hours per night. The CDC recommends 8-10 hours for adolescents, 7-9 hours for adults which makes us, on average, a sleep-deprived nation.

The Degraded Cycle

In a state of sleep deprivation, two important hormones, ghrelin and leptin, are modulated.

Normally, these two compounds maintain intelligent control of your appetite. In a state of hunger, ghrelin, which is produced in the stomach, appears in significantly higher quantities than leptin, which is a hormone made by adipose cells. After eating, relative quantities of that production invert.

Ghrelin and leptin work in concert to regulate appetite. That is, unless you are sleep deprived. A 2004 study demonstrated that production of leptin decrease while ghrelin increased in sleep-deprived participants. Hunger increases alongside that chemical inversion, “especially for calorie-dense foods with high carbohydrate content.”

This response refers back to our primary aim as humans: to stay alive. When the body is in a state of sleep deprivation, it responds accordingly – according to the fact that it is existing in a state that might kill it.

Deprive yourself of sleep long enough and you will die. Matthew Walker of UC Berkeley has a famous quote, “the shorter you sleep, the shorter your life span.” The CDC has linked sleep deprivation with depression, heart disease, obesity, and type 2 diabetes. More directly, Professor David Dinges of the University of Pennsylvania has linked sleep-deprivation with dysregulated and impaired immune system function, and sleep deprivation is linked to the top two leading causes of death in adolescents: accidents (namely, car crashes) and suicide.

The body does not want to let this happen. So, when one begins to enter a physiological state that might be leading toward an untimely end, it adjusts.

It is possible that the body adjusts production of ghrelin and leptin so that they will stockpile calories. Something must be off (or so the body perceives) to knock this vessel off its natural rhythm. So it prepares. We’re moving, it thinks. There’s a threat, it intuits. Stockpile calories, let’s load up on gas, there’s no telling how long we’ll need to go on these fumes!

Which is why, in a state of sleep deprivation, it becomes more difficult to make healthy nutritional choices.

I recently watched a colleague bring two bags of Cheetos and a can of Mountain Dew to his desk. This was his late-afternoon snack. He admitted that he had not been sleeping well and, without a plethora of options in the vending machine, he went for what “looked good.” I could not help but remind him that his lack of sleep might be making the ghrelin in his belly prematurely growl.

This situation is not uncommon. One night of poor sleep might obscure nutritional decisions and – as was the case with my coworker – lead to the consumption of artificial cheese snacks and a boat load of sodium and carbohydrates. Eventually, the fleeting positive feelings of vending-machine-eating wear off. If the demands of the workday do not allow for naps, then many will call upon their trusted allies: sugar and caffeine. One Mountain Dew contains 46g of sugar and 91mg of caffeine.

Late-day sugar and caffeine have negative effects on sleep, which will play a contributing role in nutritional decisions the following day. Caffeine has a half-life of 5 hours, which means that a 3:30pm Mountain Dew will leave 45mg of caffeine streaming through the system at bedtime.

So bedtime gets pushed back. Sleep quality degrades. And the cycle continues.

Moving Forward

Average sleep times are slipping below healthy recommendations and caffeine consumption is on an exponential rise. There seems to be a connection here. Based on the way sleep deprivation impacts hunger, it is no surprise that modern Americans get about 15% of their daily calories from fast food.

In 2015 the CDC released a report identifying the shocking fact that 100 million Americans are living with diabetes or prediabetes. Brenda Fitzgerald, MD, the Director of the Centers for Disease Control, acknowledges that this alarming statistic is complicated be the fact that “the majority [of the afflicted] don’t know it.”

The cocktail of sleep deprivation, caffeine consumption, and unhealthy diets all seem to be connected to negative outcomes and disease. So how do we move forward?

We slow down.

Step one in promoting wellness is to take a breath. Slow down. Try to see the full picture and examine our own habits first. Then examine the systems in which we operate. Then adjust or create systems so that wellness is not a luxury, but the norm.

We will have to confront some difficult truths along the way. It won’t always be easy, but it will be worth it.