Sleep & Stimulants: a Love/Hate Thing

A college counselor’s take on nonmedical use of stimulants & the sleep issues it creates

By: Bryan Harnsberger, Psy.D

Let’s be clear about this – stimulants are effective in treating ADHD symptoms.  They are not a “Limitless” pill, or whatever Jeremy Renner takes in the Bourne Legacy.  You may believe that you are doing some form of intellectual/cognitive “juicing,” but what you are really doing is exhausting yourself.  The idea that a person can gain some form of competitive advantage or improve short term cognitive performance is attractive to students.  Anything that can provide a quick fix or short cut is worth investigating.   Especially if those students live by the mantra of “work smart, not hard.”  Smart being quick and effective, hard being… hard.

Stimulants, particularly amphetamines, are very effective in providing short term improvements to alertness and some executive functioning tasks (planning, organizing and “focusing”).  The expectancy effects are also very noticeable by the user.  People don’t actually know if it helps, but they know that it works in the ways that it does. It’s like that “Curb Your Enthusiasm” episode where Larry David using Viagra even though he didn’t have Erectile Dysfunction. He secretly used the little purple pill, believing it would improve his sexual performance.  In classic Curb style, he was predictably ostracized for “juicing.”  Like ED meds for older folks, ADHD medication is appears to be an omnipresent option for those in the 18-24 age range.  Survey says that stimulants are available on college campuses.  They are around if you’re looking.  There was a study found 61.8% of college students surveyed were offered prescription stimulants for non-medical at any time in college (31% apparently reported to have said yes to the offer).2

What often gets lost in translation is how it can significantly impair your sleep.  First, let’s look at the individuals that are using stimulants non-medically.  Research indicated that these students are characteristically have lower GPAs2, have been known to skip a class or two (or a few)2, engage in excessive drinking and/or drug use2, and have some attention difficulties3.  What these findings imply is that the students using stimulants non-medically might be causing some of their attention issues by choosing not to do the healthy thing.  Alcohol and amphetamine use can both cause increases of body temperatures, which can disrupt your normal sleep cycle.  Amphetamines, if misused, can keep you up.  As a consequence, daytime sleepiness can occur.  In a 2011 study, 492 college students were surveyed about their sleep quality and non-medical stimulant use.1 The results showed that students that had a current or history of non-medical stimulant use reported worse subjective sleep quality, sleep disturbance, and global sleep scores (on the Pittsburgh Sleep Quality Scale) than nonusers.1  Guess what the most commonly reported reason for non-medical stimulant use?  “Improve work performance and concentration.”1

So how do we convince college students to stop sabotaging their sleep quality and general well-being by using stimulants to improve their alertness?  Obviously, the goal is to have students recognize they can improve their study skills, sleep habits, and engage in healthier behaviors without the use of stimulants while at college.  However, knowledge is not always liberating.  Knowing that sleep deprivation and nonmedical stimulant use can be bad may not be enough to change a student’s behavior.  We need to develop new values and ways to support students to demonstrate that academia is a not a place where success is viewed in higher regard than general well-being.  Which may be difficult, considering that college is and will be forever linked with a grading system.

References:

  1. Clegg-Kraynok, M., McBean, A. & Montgomery-Downs, H. (2011). Sleep quality and characteristics of college students who use prescription psychostimulants nonmedically. Sleep Medicine 12(6), p. 598-602.
  2. Garnier-Dykstra, L., Calderia, K., Vincent, K., O’Grady, K., & Arria, A. (2012). Nonmedical use of prescription stimulants during college: four-year trends in exposure opportunity, use, motives, and sources. Journal of American College Health, 60(3), 226-234.
  3. Arria, A., Garnier-Dykstra, L., Calderia, K., Vincent, K., O’Grady, K., Wish, E. (2011). Persistent nonmedical use of prescription stimulants among college students: possible association with Attention Deficit Hyperactivity Disorder symptoms. Journal of Attention Disorders, 15(5), p. 347-356.