May 2006
Army Uses Caffeinated Gum To Keep Sleep-Deprived Soldiers Awake - Sandra Basu
WASHINGTON-Researchers at the Walter Reed Army Institute of Research (WRAIR) in Silver Spring, Md., are hoping that a newly developed gum will help sleep deprived soldiers stay awake on the job. The gum, called Stay Alert, contains caffeine to help users stay awake.
"Caffeine, of course, is a very well accepted agent used by a large segment of the population around the world and the abuse potential is very low," said Gary Kamimori, PhD, a research physiologist at WRAIR and one of the developers of the product. "Caffeine is a very well accepted stimulant. There has been research on it, for 200-odd-some years."
Dr. Kamimori said that the benefit of Stay Alert is that it acts quickly. While he said many caffeine products take about 20 to 30 minutes to have an effect on their user, Stay Alert works in three to five minutes. This, he said, is advantageous for military personnel who work long hours and are fighting to stay awake.
"In the military we have people driving trucks all night long. We tend to fight at night, we operate 24 hours a day, seven days a week. It's usually about 20 to 30 minutes in a sleep-deprived person before you really see the effects of caffeine. With this formula, we see the effects in three to five minutes. It's really, really quick," he said.
Dr. Kamimori said that Stay Alert was brought to the military in 1999 by its inventor, Ron Ream, who at the time was with Amurol Confections Company, which was a specialty gum subsidiary of the Wrigley Company. After hearing from him about the product, the military became interested in developing it as a way of helping servicemembers stay awake.
"They [Amurol] had been test marketing the product, and at that point of time it was 50 milligrams of caffeine per gum. The gum held the caffeine and they were able to hide the bitterness of caffeine, and it supposedly delivered it faster," Dr. Kamimori said. "Their test marketing showed that their packaging wasn't flashy enough, the name wasn't catchy enough, and the flavor was terrible. So they never actually marketed the program at that point of time. Mr. Ream then met my commander, came in and gave his talk on the product."
In the year 2000 WRAIR received congressional money to do a study on the gum, which was conducted to validate what Ream had already said about the product. Through the study, WRAIR found that caffeine in the chewing gum form was absorbed by the body about four to five times faster then caffeine taken in any other form.
"Anything that goes into the stomach takes a fair amount of time to get into the body. In the chewing gum form, the caffeine is predominantly absorbed through the lining of the mouth. Because of that, it gets into the body, four to five times faster and is working faster. After we validated that it does go to the body faster, the [U.S. Army] Medical Research and Materiel Command started funding research for [the gum] to deal with fatigue [in military personnel]," Dr. Kamimori said.
Staying Awake
Dr. Kamimori said that when WRAIR originally began improving the gum, each piece contained 50 milligrams of caffeine. WRAIR researchers then conducted research to determine how much caffeine and how often the gum should be taken by a user. WRAIR researchers found that 200 milligrams every two hours was the best dosage during a night without sleep.
"We found out if you gave 200 milligrams, every two hours during the night without sleep, that you could maintain alertness at 100 per cent on a relatively boring task. We looked at different doses of caffeine, [and] 200 milligrams was the most effective," he said.
In another study, Dr. Kamimori said that they wanted to determine what dosage of caffeine in the gum was most effective among individuals who generally have a high intake of caffeine.
"Commanders sometimes don't sleep much and they are drinking 10 [to] 15 cups of coffee a night. Our study looked at high habitual use versus low use. We took a bunch of military soldiers that tended to use a lot of caffeine and we took a bunch of soldiers who used almost no caffeine and we did the same study looking at some higher doses [of caffeine in the gum] and some lower doses. We found that it really didn't make much difference during one night without sleep. Two hundred milligrams [of caffeine in the gum] was still the best dose. When we gave 300 milligrams, we actually started seeing some negative side effects. We had someone get kind of hyperactive. We had one person get severe nausea, stomach upset, so 200 milligrams is the best dose for the average person, whether they be a high or low user," he said.
Gum
The gum, which is in pellet form, has been available for troops since last month and contains 100 milligrams of caffeine in each piece. Users are recommended to take one piece of the gum, chew it for five minutes and if they are not alert, chew a second piece.
"The product has been available since April of this year. We know that orders have been placed for units in Iraq and Afghanistan and training units here in the States," Dr. Kamimori said.
Dr. Kamimori said that obtaining caffeine through gum has several advantages over coffee for a servicemember, including its quick impact and convenience.
"Most people take more caffeine than they need. That's because it takes so long to work. When you wake up and have your first cup of coffee, it doesn't start working for 20 minutes. That's the thing with the gum...if you are tired and driving down the road and get the head bob, you pop a piece or two pieces and boom, two minutes later you are good to go," he said.
Dr. Kamimori also said that gum does not have the acids associated with coffee that can cause an upset stomach. In addition, he noted that because gum is not a fluid like coffee, it will not cause the user to have to urinate.