Caffeine Consumption, Sleep Quality and Mental Health Outcomes Among Malaysian University Students

Authors

  • Norhaslina Sulaiman University Malaysia Terengganu, Kuala Nerus, Malaysia
  • Asma Ali University Malaysia Terengganu, Kuala Nerus, Malaysia
  • Muhamad Khairul Zakaria University Malaysia Terengganu, Kuala Nerus, Malaysia
  • Mohd Radhi Abu Shahim University Malaysia Terengganu, Kuala Nerus, Malaysia
  • Sim Why Jean Institut Masa Depan Malaysia, Bukit Bandaraya, Malaysia
  • Abbe Maleyki Mhd Jalil Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia

DOI:

https://doi.org/10.55489/njcm.150520243858

Keywords:

Caffeine overdose, depression, anxiety, university students, south-east Asia

Abstract

Background: Recognizing the scarcity of data on caffeine consumption among university students in Malaysia, this study was designed to first characterize the habitual caffeine intake within this group. This study further investigated the potential association between these caffeine consumption patterns and sleep quality and mental health status.

Methodology: The study employed an online self-administered questionnaire to assess habitual caffeine intake from various products. Sleep quality and mental health were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale-21 (DASS-21), respectively.

Results: 78% of the respondents consumed caffeinated products daily within the safe level recommended by the European Food Safety Authority (£400mg/day). Only 2.6% of the students consumed caffeine exceeding the recommended limit. The median total daily caffeine intake was 100mg/day. Most students had poor sleep quality (77.3%), with 43.5%, 49.5%, and 33.0% reporting varying levels of depression, anxiety, and stress, respectively. Odds ratio calculations revealed respondents consuming less than or more than 400 mg/day of caffeine did not show significantly different odds of poor sleep quality, depression, anxiety, or stress compared to non-consumers.

Conclusions: This study highlights the need for further localized research on caffeine's effects among Malaysian university students regarding caffeine consumption, sleep, and mental health.

References

Aboelnaga SMH. Caffeine and Its Impact with Physical and Status of Mental Health among University Students in the United Kingdom". Journal of Pharmaceutical Research International. 2021; 33(1): 32-38. Doi: https://doi.org/10.9734/jpri/2021/v33i131135

Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Additives and Contaminants. 2003; 20(1): 1-30. Doi: https://doi.org/10.1080/0265203021000007840 PMid:12519715

Buboltz WC, Brown F, Soper B. Sleep habits and patterns of college students: A preliminary study. Journal of the American College Health Association. 2001 50(3): 131-135. Doi: https://doi.org/10.1080/07448480109596017 PMid:11765249

Raley H, Naber J, Cross S, Perlow M. The Impact of Duration of Sleep on Academic Performance in University Students. Madridge Journal of Nursing. 2016; 1(1): 11-18. Doi: https://doi.org/10.18689/mjn-1000103

Atikahramli NA, Sriperumbuduru VPK, Ghazi HF, Dalayi NJ. A study of caffeine consumption patterns and dependence among management and science university students. Indian Journal of Forensic Medicine and Toxicology. 2019; 13(1): 101-105. Doi: https://doi.org/10.5958/0973-9130.2019.00021.5

Rajeswaran S, Zulkhairie Bin Zulkifli M, Atasya Binti Budi Irawan N, Binti Mohd Seh N, Ser Yin L. A Cross Sectional Study on Caffeine Consumption and Caffeine Expectancy Among Undergraduate Medical Students. American Journal of Food Science and Health. 2020; 6(1): 12-22.

Tien Ngu S, Masalamany K, Abd Manan N, Adam SK. Sleep Quality among Pre-Clinical Medical Students in Universiti Putra Malaysia and Universiti Malaya Malaysia. Education in Medicine Journal. 2017; 9(3): 23-31. Doi: https://doi.org/10.21315/eimj2017.9.3.3

Amir Hamzah NS, Nik Farid ND, Yahya A, Chin C, Su TT, Rampal SRL, Dahlui M. The Prevalence and Associated Factors of Depression Anxiety and Stress of First Year Undergraduate Students in a Public Higher Learning Institution in Malaysia. Journal of Child and Family Studies. 2019; 28(12): 3545-3557. Doi: https://doi.org/10.1007/s10826-019-01537-y

Cheung DK, Tam DKY, Tsang MH, Zhang DLW, Lit DSW. Depression anxiety and stress in different subgroups of first-year university students from 4-year cohort data. Journal of Affective Disorders. 2020; 274(May): 305-314. Doi: https://doi.org/10.1016/j.jad.2020.05.041 PMid:32469820

Delara M, Woodgate RL. Psychological Distress and its Correlates among University Students: A Cross-Sectional Study. Journal of Pediatric and Adolescent Gynecology. 2015; 28(4): 240-244. Doi: https://doi.org/10.1016/j.jpag.2014.08.012 PMid:26024934

Di Benedetto M, Towt CJ, Jackson ML. A Cluster Analysis of Sleep Quality Self-Care Behaviors and Mental Health Risk in Australian University Students. Behavioral Sleep Medicine. 2020; 18(3): 309-320. Doi: https://doi.org/10.1080/15402002.2019.1580194 PMid:30821507

Kotera Y, Ting SH, Neary S. Mental health of Malaysian university students: UK comparison and relationship between negative mental health attitudes self-compassion and resilience. Higher Education. 2021; 81(2): 403-419. Doi: https://doi.org/10.1007/s10734-020-00547-w

Tayefi B, Eftekhar M, Tayefi M, Darroudi S, Khalili N, Mottaghi A, Shanjani ZH, Nojomi M. Prevalence and Socio-Demographic Correlates of Mental Health Problems Among Iranian Health Sciences Students. Academic Psychiatry. 2020; 44(1): 73-77. Doi: https://doi.org/10.1007/s40596-019-01121-y PMid:31625073

Faris MAIE, Jahrami H, Al-Hilali MM, Chehyber NJ, Ali SO, Shahda SD, Obaid RS. Energy drink consumption is associated with reduced sleep quality among college students: a cross-sectional study. Nutrition and Dietetics. 2017; 74(3): 268-274. Doi: https://doi.org/10.1111/1747-0080.12289 PMid:28731611

Jahrami H, Al-mutarid M, Penson PE, Faris MA. Intake of Caffeine and Its Association with Physical and Mental Health Status among University Students in Bahrain. Foods. 2020; 9(473). Doi: https://doi.org/10.3390/foods9040473 PMid:32290044 PMCid:PMC7230284

Jin M, Yoon C, Ko H, Kim H, Kim A, Moon H, Jung S. The Relationship of Caffeine Intake with Depression Anxiety Stress and Sleep in Korean Adolescents. 2016; 111-116. Doi: https://doi.org/10.4082/kjfm.2016.37.2.111 PMid:27073610 PMCid:PMC4826990

Mwape RK, Mulenga D. Consumption of Energy Drinks and Their Effects on Sleep Quality among Students at the Copperbelt University School of Medicine in Zambia. Sleep Disorders. 2019; 1-7. Doi: https://doi.org/10.1155/2019/3434507 PMid:30863644 PMCid:PMC6377981

Patrick Y, Lee A, Raha O, Pillai K, Gupta S, Sethi S, Mukeshimana F, Gerard L, Moghal MU, Saleh SN, Smith SF, Morrell MJ, Moss J. Effects of sleep deprivation on cognitive and physical performance in university students. Sleep and Biological Rhythms.2107; 15(3): 217-225. Doi: https://doi.org/10.1007/s41105-017-0099-5 PMid:28680341 PMCid:PMC5489575

Cochran WG. Sampling techniques. Third edition. New York: John Wiley, Sons; 1977.

El-Nimr N, Bassiouny S, Tayel D. Pattern of Caffeine Consumption Among University Students. Journal of High Institute of Public Health. 2019; 0(0): 153-160. Doi: https://doi.org/10.21608/jhiph.2019.56579

Basile AJ, Kirkton SD, Hedrick MS, Carey HV, Sweazea KL. Defining comparative physiology: results from an online survey and systematic review. American Journal of Physiology-Regulatory Integrative and Comparative Physiology. 2021; 320(6): R938-R944. Doi: https://doi.org/10.1152/ajpregu.00220.2020 PMid:33882704

Salmiah MS, Saliluddin SM, Mohd Hafeez I. Pre-Hypertension And It's Associated Factors Among Students In A Pre-Universitycollege In Malaysia. 2016; 3(5): 70-85.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. Buysse DJ Reynolds CF Monk TH Berman SR Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213. Doi: https://doi.org/10.1016/0165-1781(89)90047-4 PMid:2748771

European Food Safety Authority (EFSA). Scientific Opinion on the safety of caffeine. EFSA Journal. 2015; 13(5):4120. Doi: https://doi.org/10.2903/j.efsa.2015.4102

Farah NMF, Yee TS, Rasdi HFM. Self-reported sleep quality using the malay version of the pittsburgh sleep quality index (PSQI-M) in Malaysian adults. International Journal of Environmental Research and Public Health. 2019; 16(23): 1-10. Doi: https://doi.org/10.3390/ijerph16234750 PMid:31783607 PMCid:PMC6926836

Beck SL, Schwartz AL, Towsley G, Dudley W, Barsevick A. Psychometric evaluation of the Pittsburgh sleep quality index in cancer patients. Journal of Pain and Symptom Management. 2004; 27(2): 140-148. Doi: https://doi.org/10.1016/j.jpainsymman.2003.12.002 PMid:15157038

Zunhammer M, Eichhammer P, Busch V. Sleep Quality during Exam Stress: The Role of Alcohol Caffeine and Nicotine. PLoS ONE. 2014; 9(10). Doi: https://doi.org/10.1371/journal.pone.0109490 PMid:25279939 PMCid:PMC4184882

Shamsuddin K, Fadzil F, Ismail WSW, Shah SA, Omar K, Muhammad NA, Jaffar A, Ismail A, Mahadevan R. Correlates of depression anxiety and stress among Malaysian university students. Asian Journal of Psychiatry. 2013; 6(4): 318-323. Doi: https://doi.org/10.1016/j.ajp.2013.01.014 PMid:23810140

Ramli M, Rosnani S, Fasrul AA. Psychometric Profile of Malaysian version of the Depressive Anxiety and Stress Scale 42-item (DASS-42). MJP Online Early. 2012; 1(1) 7.

Lovibond P, Lovibond SH. The Structure Of Negative Emotional States: Comparison Of The Depression Anxiety Stress Scales (DASS) With The Beck Depression And Anxiety Inventories. Medical and Biological Engineering and Computing. 1995; 33(3) 335-343. Doi: https://doi.org/10.1016/0005-7967(94)00075-U PMid:7726811

Jahrami H, Dewald-Kaufmann J, Faris MAI, AlAnsari AMS, Taha M, AlAnsari N. Prevalence of sleep problems among medical students: a systematic review and meta-analysis. Journal of Public Health (Germany). 2020; 28(5): 605-622. Doi: https://doi.org/10.1007/s10389-019-01064-6

Lasode AO, Awote MF. Challenges Faced by Married University Undergraduate Female Students in Ogun State Nigeria. Procedia - Social and Behavioral Sciences. 2014; 112(Iceepsy 2013): 102-113. Doi: https://doi.org/10.1016/j.sbspro.2014.01.1144

Tea in Malaysia Overview and Outlook. Available at: https://www.ocha.net/english/association/information/documents/CKLiewArticle.pdf. Accessed on 19 Jun 2021.

Isa ZM, Anuar AA, Azmi AD, Selvan ST, Hisham NS, Qing YZ. Does Caffeine Intake Influence Mental Health Of Medical Students? Malaysian Journal of Public Health Medicine. 2021; 21(2): 22-28. Doi: https://doi.org/10.37268/mjphm/vol.21/no.2/art.626

Nasir SA, Nasir GA, Usman A, Razi-Ur-Rehman Fatima T, Nasir SA, Muzaffar N, Aftab S, Ali M. Prevalence and pattern of caffeine consumption among university students - A cross-sectional study. Pakistan Journal of Medical and Health Sciences. 2018; 12(3): 983-986.

Choi J. Motivations influencing caffeine consumption behaviors among college students in Korea: Associations with sleep quality. Nutrients. 2020; 12(4). Doi: https://doi.org/10.3390/nu12040953 PMid:32235502 PMCid:PMC7231156

Reid SD, Ramsarran J, Brathwaite R, Lyman S, Baker A, Cornish DÕAC, Ganga S, Mohammed Z, Sookdeo AT, Thapelo CK. Energy drink usage among university students in a Caribbean country : Patterns of use and adverse effects. Journal Of Epidemiology And Global Health November. 2014. Doi: https://doi.org/10.1016/j.jegh.2014.05.004 PMid:25922319 PMCid:PMC7320484

Alsaedi EQ, Alsaedi MQ. A Cross Sectional Study of the Relationship of Caffeine Consumption Stress and Theirs Effects on the Academic Performance among Female Students in Taibah University. 2017;3(6).

Mackus M, van de Loo AJAE, Benson S, Scholey A, Verster JC. (2016). Consumption of caffeinated beverages and the awareness of their caffeine content among Dutch students. Appetite. 2016; 103: 353-357. Doi: https://doi.org/10.1016/j.appet.2016.04.038 PMid:27142708

Mahoney CR, Giles GE, Marriott BP, Judelson DA, Glickman EL, Geiselman PJ, Lieberman HR. Intake of caffeine from all sources and reasons for use by college students. Clinical Nutrition. 2019; 38(2): 668-675. Doi: https://doi.org/10.1016/j.clnu.2018.04.004 PMid:29680166

Al Ghali RM, Al Shaibi H, Al Majed H, Haroun D. Caffeine Consumption among Zayed University Students in Dubai United Arab Emirates: A Cross-Sectional Study. Arab Journal of Nutrition and Exercise (AJNE). 2017; 1(3): 131. Doi: https://doi.org/10.18502/ajne.v1i3.1230

Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Frontiers in Psychiatry. 2017; 8(June). Doi: https://doi.org/10.3389/fpsyt.2017.00080 PMid:28603504 PMCid:PMC5445139

Nurismadiana I, Lee K. Factors Associated With Sleep Quality Among Undergraduate Students At a Malaysian Public University. International Journal of Public Health and Clinical Sciences. 2018; 5(6): 373-391. Doi: https://doi.org/10.32827/ijphcs.5.6.373

Khan Awan K, Talha Farooq M, Farooq P, Yasir Tarar M. The sleep quality using Pittsburgh sleep quality index. Pakistan Journal of Neurological Sciences (PJNS). 2018; 13(2): 17.

Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Doak S, Folk SYL, Tucker RM. The effects of sleep quality and resilience on perceived stress dietary behaviors and alcohol misuse: A mediation-moderation analysis of higher education students from asia europe and north america during the COVID-19 pandemic. Nutrients. 2021; 13(2): 1-22. Doi: https://doi.org/10.3390/nu13020442 PMid:33572863 PMCid:PMC7911351

Arsalan B, Ahmed F. Sleep Hygiene and Quality among Medical Students. 2015;2(10): 487-490.

Friedrich A, Schlarb AA. Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students. Journal of Sleep Research. 2018; 27(1): 4-22. Doi: https://doi.org/10.1111/jsr.12568 PMid:28618185

Hershner S, O'Brien LM. Sleep Education for College Students. Journal of Clinical Sleep Medicine. 2018; 14(7): 1271-1272. Doi: https://doi.org/10.5664/jcsm.7248 PMid:29991435 PMCid:PMC6040798

Siraj HH, Salam A, Hani AC, Chong SH, Saidatul AS, Faiz MK, ... , Nabishah M. Self awareness and reflective skills in the promotion of personal and professional development of future medical professionals. Education in Medicine Journal. 2013; 5(4). Doi: https://doi.org/10.5959/eimj.v5i4.171

Kulig CE, Persky AM. Transition and student well-being -why we need to start the conversation. American Journal of Pharmaceutical Education. 2017; 81(6): 1-2. Doi: https://doi.org/10.5688/ajpe816100 PMid:28970601 PMCid:PMC5607710

Al Sawah M, Ruffin N, Rimawi M, Concerto C, Aguglia E, Chusid E Infortuna C, Battaglia F. Perceived stress and coffee and energy drink consumption predict poor sleep quality in podiatric medical students: A cross-sectional study. Journal of the American Podiatric Medical Association. 2015; 105(5): 429-434. Doi: https://doi.org/10.7547/14-082 PMid:26429613

Winston AP, Hardwick E, Jaberi N. Neuropsychiatric effects of caffeine. Advances in Psychiatric Treatment. 2005; 11(6): 432-439. Doi: https://doi.org/10.1192/apt.11.6.432

Kole J, Barnhill A. Caffeine Content Labeling: A Missed Opportunity for Promoting Personal and Public Health. Journal of Caffeine Research. 2013; 3(3): 108-113. Doi: https://doi.org/10.1089/jcr.2013.0017 PMid:24761278 PMCid:PMC3777296

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Published

2024-05-01

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1.
Sulaiman N, Ali A, Zakaria MK, Abu Shahim MR, Sim Why Jean, Mhd Jalil AM. Caffeine Consumption, Sleep Quality and Mental Health Outcomes Among Malaysian University Students. Natl J Community Med [Internet]. 2024 May 1 [cited 2024 Dec. 22];15(05):370-8. Available from: https://njcmindia.com/index.php/file/article/view/3858

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