Available online at:
https://cc.arcabc.ca/islandora/object/cc%3Apsycjournal

J Camosun Psyc Res. (2022). Vol. 4(1), pp. 266-286.
Submitted Winter 2022; accepted June 2022.

What Are the Effects of Caffeine on Mental Health?
Authors: Ashley Pifer* and Amye St Arnault
Supervising Instructor: Michael Pollock, Psyc 245 (“Drugs & Behaviour”)
Department of Psychology, Camosun College, 3100 Foul Bay Road, Victoria, BC, Canada V8P 5J2
*Corresponding author email: ashley.pifer23@gmail.com

ABSTRACT
In this paper, we sought to understand how excessive caffeine consumption can lead to an
increase in anxiety and depression resulting from disturbed sleep so we could learn to avoid
these side effects while still enjoying caffeinated beverages. Previous research has found that
caffeine consumption is associated with anxiety, decreases in serotonin levels and mental health
effects to the extent to which caffeine disrupts sleep. In our first (correlational) study, we tested
the strength of these relationships by examining naturalistic daily changes in their variables
longitudinally over a period of twelve days. We measured anxiety and depression levels each by
using a 10-point Likert scale, serotonin levels by filling out a daily Athens Insomnia Scale, and
caffeine consumption by filling out a daily Caffeine Consumption Questionnaire (CC-Q). Based
on the strength of correlation found between caffeine and serotonin in our correlational study, we
then conducted a second (experimental) study to test for a causal relationship between these two
variables. Over an 11-day period, we randomly assigned a participant each day to either a
caffeinated condition or a decaffeinated condition using a double blind procedure and had the
participant fill out the Athens Insomnia Scale each following morning While our correlational
study failed to find statistically significant correlations of caffeine intake with anxiety,
depression, or serotonin, the manipulation of caffeine in our experimental study produced a
significant increase in insomnia. The results of our experimental study suggest that lowering the
amount of caffeine you drink in a day can increase your sleep quality.
1. Introduction
1.1 Research Problem
Caffeine consumption can negatively
impact mental health which, in turn,
diminishes the quality of life. Caffeine
consumption also appears to be a normal
routine of many college students but its
effects on the human body aren’t as widely
known. We want to understand how caffeine
affects mental health and if there is a way to
limit its negative effects. For example, as

one of the authors of this paper suffers from
caffeine addiction as well as anxiety, we
have noticed a big difference in mental
health when drinking caffeine or not. With
this research, we hope to understand not
only how caffeine directly affects the
nervous system but also find solutions for
those who suffer from it. Caffeine can also
reduce sleep quality and/or quantity,
lowering energy and mood the next day. Our
hope is to understand how caffeine induces
anxiety and sleep-related depression to
minimize side effects through strategic
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dosing. This will allow us to continue
enjoying caffeinated beverages without the
negative consequences.
1.2 Literature Review
One previously found mental health
effect of caffeine consumption is an increase
of anxiety symptoms. For example, in an
experimental study done by O’Neill et al.
(2016), researchers used adolescent male
Sprague-Dawley rats and had them consume
caffeine for 28 days while age-matched
control rats consumed only water. After
seven days of withdrawal from caffeine, the
brain tissue of the rats was tested. Based on
these results, the researchers suggested that
adolescents who drink caffeine may have
dysregulation of the neuroendocrine stress
response system. It also found that brain
areas involved in anxiety, such as the
hypothalamus and the amygdala, showed a
significant increase in basal corticotropinreleasing factor mRNA during caffeine
withdrawal, suggestive of increased stress.
Another previously found mental health
effect of caffeine consumption is depression
from sleep disruption. For example, in a
double-blind controlled trial study with
California University graduate-level
students, Distelberg et al. (2017) had
participants randomly assigned to either a
caffeine-treatment condition (710mL of
caffeinated coffee containing 450 mg of
caffeine) or a decaf-control condition (710
mL of decaf coffee containing 12 mg of
caffeine). Subjective questionnaires were
administered on day 5 of the pre-treatment
abstinence phase, as well as day 3 and 5 of
the treatment and post-treatment abstinence
phases. The Insomnia Severity Index (ISI)
was used to measure sleep issues, including
difficulties falling asleep, staying asleep, and
waking too early, while a 7-point Likert
scale was used to access sleep quality (0 =

“Between 0 and 1 hours”...7 = “More than
10 hours”). Finally, subscales from the Brief
Symptom Inventory (BSI) and the Duke
Health Profile (DHP) were used to measure
depression. The BSI is a 53-item
questionnaire, and the DHP is a 17-item
questionnaire, 4 of which measure
depression, anxiety, pain, and disability. The
ISI and sleep quality measures showed a
significant difference between groups, with
the caffeine condition reporting more sleep
problems and fewer hours of sleep as
compared to the decaf control condition.
Depression results were more complex, with
participants reporting the most depressive
symptoms at the beginning and end of the
treatment phase, and as many as 3 days into
the post-treatment phase. Based on these
results, researchers suggest that caffeine’s
negative impact on sleep contributes to
depressive symptoms the next day.
A third previously found mental health
effect of caffeine consumption is a decrease
of serotonin levels. For example, in an
experimental study done by Arnold et
al.(2019), researchers used male rats in late,
middle, and early adolescence and had them
consume caffeine for 28 days and then water
for 28 days. Researchers then dissected the
brains of the rats and tested their tissue. The
researchers found that chronic caffeine
consumption in adolescences lead to longterm decreasing in the functioning of
serotonergic brain areas therefore may
contribute to anxiety-like symptoms.
1.3 Hypotheses
Based on the above literature review, we
predicted the following hypotheses:
Hypothesis #1: If caffeine consumption
increases then anxiety will increase.
Hypothesis #2: If caffeine consumption
increases then depression will increase.
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Hypothesis #3: If caffeine consumption
increases then serotonin levels will decrease.
2. Methods
2.1 Participants
The 2 authors of this paper served as the
participants in its studies. The participants
ranged in age from 28 to 34 years old, with
an average age of 31 years, and included 2
cisgender women. The participants were
both undergraduate students at Camosun
College who completed the current studies
as an assignment for Psyc 245 (“Drugs &
Behavior”) and were grouped together due
to their mutual interest in the effects of
caffeine on mental health. Both participants
were regular caffeine users with a moderatehigh daily intake and one participant was
diagnosed with anxiety and severe
depression.
2.2 Correlational Study Methods
We first performed a correlational study
to test concurrently all of our hypotheses by
examining naturalistic daily changes in their
variables longitudinally. Each participant
always kept a study journal with them over
this study’s one-week period in order to
record self-observations of daily caffeine
intake as the predictor variable, and anxiety,
depression, and serotonin levels as outcome
variables.
2.2.1 Anxiety
To measure anxiety, a 10-point Likert
scale: (0= absence of symptoms, 5=
moderate worry, physical agitation; 10= out
of control behaviour, hitting, rhyming
voices) was used (see Appendix B).
Beginning on day 2 of the 12- day study,
participants recorded their anxiety levels at
three separate occasions (waking, afternoon,
and before bed) using their preferred method
(phone, notebook, or laptop) for each day of

the study. Based on these calculations, the
average anxiety level of each participant for
each following day was recorded and
analyzed.
2.2.2 Depression
To measure depression, a 10-point
Likert scale (0 = absence of symptoms; 5 =
definite malaise, insomnia; 10 = despair,
suicidal feelings) was used (see Appendix
B). Beginning on day 2 of the 12-day study,
participants rated and recorded their
depression levels at 3 separate times (upon
waking, midday, and before bed) in either a
notebook or cellphone for each day of the
study. From these records, the average daily
depression level of each participant for each
following day was calculated and analyzed.
2.2.3 Serotonin Levels
To measure serotonin levels, participants
completed the Athens Insomnia Scale (See
Appendix C). The scale consisted of 8
insomnia symptoms where each item is
scored on a scale of 0 (none) to 3 (severe)
with a total score 0-24 where <12 is the
participant may not be suffering from
insomnia and 12-24 participants are likely to
be suffering from insomnia. Participants
completed this scale daily (preferably after
waking) for two weeks. Higher levels of
insomnia on this scale were interpreted as
indicating lower levels of serotonin, since
accumulation of this neurotransmitter is
responsible for promoting sleep.
2.2.4 Caffeine
To measure caffeine consumption, all the
participants filled out a Caffeine
Consumption Questionnaire (CC-Q) on a
daily basis (See Appendix A). The
questionnaire includes 9 broad items that
contain caffeine: for instance, one is coffee
while another is a chocolate bar. Participants
had to pick one or more of the nine options
as well as fill out the amount consumed that
day using milligrams (mg). This was offset
by the average number of ounces per day as
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well as the average total per day. Based on
the sum of each of these numerical answers,
one’s level of caffeine consumption was
assessed.
2.3 Correlational Study Planned Analyses
To assess the strength and statistical
significance of associations between
variables predicted by our 3 hypotheses, we
performed Pearson product moment
correlations of their predictor variable daily
caffeine intake with their outcome variables
anxiety, depression, and serotonin levels.
For testing Hypothesis #1, we correlated
each participant's average daily anxiety
score on each following day by the total
amount of daily caffeine consumed. For
testing Hypothesis #2, we correlated each
participant’s average daily depression score
on each following day by the total amount of
daily caffeine consumed. For testing
Hypothesis #3, we correlated each
participant’s average insomnia score each
following morning upon waking by the total
amount of daily caffeine consumed. We
performed all of the above correlations
separately for each participant as well as
using data pooled across all of the
participants. For the correlations using
pooled data, in addition to using the raw
data, we also performed correlations after
we had first transformed the data from each
participant into z-scores in order to
standardize differences in averages and
variability seen between the participants in
their data and thus make them more
comparable. A correlation coefficient was
considered statistically significant if the
probability of its random occurrence (p) was
< .05 (i.e., less than 5% of the time expected
by chance alone).
2.4 Experimental Study Methods
Based on the strength of the correlation
between caffeine consumption and serotonin

levels found in our correlational study, we
then chose to conduct an experimental study
to test for a causal relationship between
these two variables from Hypothesis # 3: If
caffeine consumption increases then
serotonin levels will tend to decrease.
We manipulated the independent
variable, caffeine consumption, over an 11day period by randomly assigning (through
coin flip) a participant each day to either
consume a regular caffeinated coffee or a
decaffeinated coffee using in a double blind
procedure. The participant’s partners,
friends, or family members flipped a coin
each day when they were to consume
caffeine. When the coin was flipped to
heads, the participants drank caffeinated
coffee and when the coin was flipped to
tails, the participants drank a decaffeinated
coffee. The next morning, participants
would record serotonin levels by filling out
an Athens Insomnia Scale (See Appendix
D). Higher levels of insomnia on this scale
were interpreted as indicating lower levels
of serotonin, since accumulation of this
neurotransmitter is responsible for
promoting sleep.Once the data was recorded,
the partner, friend, or family member who
assisted with the experimental condition,
then told the participant what method was
assigned to them (caffeinated coffee or
decaffeinated coffee) and data was analyzed
correspondingly.
On caffeine experimental days,
participants drank 16oz of Tim Horton’s
Dark Roast coffee, containing 260mg of
caffeine. On decaf control days, participants
drank 16oz of Tim Horton’s Dark Roast
decaf coffee, containing 12mg of caffeine.
In both conditions, the participant added 2
tablespoons of cream to their coffee and 2
tablespoons of sugar. The experimental
caffeine amount was based on the
approximate average the participant usually
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drank. The coffee was consumed shortly
after waking, within a 1-hour period.
To ensure the participant remained
unaware of their daily assigned conditions,
the participant stayed out of the kitchen
while their partner acted as an assistant who
prepared each day’s coffee. Following
administration, the assistant recorded the
assigned condition in a private journal. The
following day, the participant took
dependent variable measurements and then
collected the identity of the previous day’s
condition from their assistant. To avoid
potential taste differences between
conditions, the participant chose a decaf
coffee that had the same roast level as their
regular caffeinated coffee. Creamer and/or
sugar were also added to minimize any
potential taste differences.
2.5 Experimental Study Planned Analyses
To assess the statistical significance of
differences seen in serotonin levels on
decaffeinated coffee vs caffeinated coffee,
Student’s t-tests were performed. We
performed t-tests separately for each
participant as well as using data pooled
across all the participants. For the t-tests
using pooled data, in addition to using the
raw data, we also performed t-tests after we
had first transformed the data from each
participant into z-scores to standardize
differences in averages and variability seen
between the participants in their data and
thus make them more comparable. An
average difference between conditions was
considered statistically significant if, using a
one-tailed distribution (i.e., to determine if
there is a difference between groups in a
specific direction), the probability of its
random occurrence (p) was < .05 (i.e., less
than 5% of the time expected by chance
alone).
3. Results

3.1 Correlational Study Results
As shown in Table 1, none of our
correlations resulted in any statistical
significance (p < .05). For hypothesis #1,
there was no significant correlation found
between caffeine consumption anxiety using
either pooled raw data (r = 0.04, p = 0.81;
see Figure 3) or pooled standardized data (r
= 0.07, p = 0.70; see Figure 4). For
hypothesis #2, there was no significant
correlation found between caffeine
consumption and depression using either
pooled raw data (r = 0.04, p = 0.83; see
Figure 5) or pooled standardized data (r =
0.10, p = 0.57; see Figure 6). For hypothesis
#3, there was no significant correlation
found between caffeine consumption and
insomnia scores using either pooled raw data
(r = 0.08, p = 0.65; see Figure 1) or pooled
standardized data (r = -0.13, p = 49; see
Figure 2). Based on a comparison of the
pooled standardized data for each of the
three hypotheses, caffeine consumption was
found to be most strongly correlated with
insomnia scores (r = -0.13).
3.2 Experimental Study Results
As shown in Table 2, there was a
significant difference in insomnia scores
between the caffeinated coffee and
decaffeinated coffee conditions (p = 7.59E07 using both raw and standardized data).
Using the raw data, insomnia scores
following the caffeinated coffee condition
showed a mean of 16.45 (S.D.= 3.45) while
following the decaffeinated coffee condition
the mean was 5.40 (S.D.= 3.89) (see Figure
7). Using the standardized data, the z-scores
for insomnia levels following the caffeinated
coffee condition the mean was 0.79 (S.D.=
0.52) while following the decaffeinated
coffee condition the mean was -0.87 (S.D.=
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0.58) (see Figure 8). Assuming that
increases in insomnia are associated with
decreases in serotonin, these results suggest
that our caffeinated coffee condition
decreased serotonin levels in comparison to
the decaffeinated coffee condition.
4. Discussion
4.1 Summary of Results
Based on previous research, we
hypothesized that an increase in caffeine
consumption would be followed by
increases in two variables and a decrease in
another variable: anxiety increase
(Hypothesis #1), depression increase
(Hypothesis #2), and serotonin decrease
(Hypothesis #3). Data pooled across
participants in our correlational study did
not support any of the hypotheses. However,
our experimental study showed significant
differences in insomnia scores between its
caffeinated coffee and decaffeinated coffee
conditions, which supported our Hypothesis
#3.
4.2 Relation of Results to Past Research
Our correlation study indicated that
caffeine and anxiety did not have a
significant correlation, which is not
consistent with previous research. According
to the study conducted by O’Neill et al.
(2016), caffeine and anxiety should be
positively correlated. A difference in
methodology between our study and the
O’Neill et al. (2016) study that could
possibly account for their discrepancy in
results is that we did not use the same type
of participants: female college students in
our study versus male Sprague-Dawley rats
in their study. Further studies should be
done on the study of human subjects instead
of non-human subjects to provide a more

relevant correlation between caffeine and
anxiety for humans.
Our correlational study failed to show
that caffeine increases depression as
reported by previous research. In addition to
increased insomnia, Distelberg et al. (2017)
found that depression, measured using
subscales from the BSI and the DHP,
increased as a result of caffeine
consumption. Based on this research, we
hypothesized that caffeine’s negative impact
on sleep would contribute to an increase in
depressive symptoms the following day, but
the data failed to confirm this hypothesis.
Differences in methodology may account for
the discrepant results. Distelberg et al.
(2017) blindly experimentally administered
set amounts of caffeine to participants while
in our nonexperimental study participants’
caffeine consumption in our study varied
from day-to-day. Future studies should test
to confirm that varied caffeine intake and
participant knowledge don’t distort
subjective depression results. In addition,
while Distelberg et al. (2017) had
participants with no history of mental health
conditions or chronic physical health
limitations, our study consisted of
participants with known mental health
issues. Future studies should examine the
differences of caffeine’s impact on
participants with, and without, mental health
conditions.
Our correlation study indicated that
caffeine and serotonin are not significantly
correlated, which is not consistent with
previous research. According to the study
conducted by Arnold et al. (2019), caffeine
and serotonin levels are negatively
correlated. A difference in methodology
between this study and the Arnold et al.
(2019) study that could possibly account for
their discrepancy in results include
differences in participant types: female
college students in our study versus
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adolescent male rats in their study. In
addition, we measured serotonin indirectly
by the inverse of scores on the Athens
Insomnia Scale while Arnold et al. (2019)
measured serotonin levels directly.
However, our experimental study indicated
that caffeine did significantly decrease
serotonin levels, which is consistent with
previous research. Further studies should
verify whether the caffeine-induced
increases insomnia are indeed associated
with decreases in serotonin and whether this
has any effect upon mental health, such as
anxiety and depression.
4.3 Implications of Results
Our study could be a step in the right
direction at helping the mental well-being of
college students as well as young
adolescents on the side effects of too much
caffeine. As a result of our study, we
discovered just how much caffeine can
affect our insomnia, with lowering the
amount of caffeine you drink in a day
improving sleep quality. It remains to be
seen whether these effects also produce
changes in mental health.

References
Arnold, M. R., Williams, P. H., McArthur, J.
A., Archuleta, A. R., O’Neill, C. E.,
Hassell, J. E., Smith, D. G., Bachtell, R.
K., & Lowry, C. A. (2019). Effects of
chronic caffeine exposure during
adolescence and subsequent acute
caffeine challenge during adulthood on
rat brain serotonergic systems.
Neuropharmacology, 148, 257–271.
https://doiorg.libsecure.camosun.bc.ca:2443/10.101
6/j.neuropharm.2018.12.019
Distelburg, B. J., Staack, A., Elsen, K. D., &
Sabate, J. (2017). The effect of coffee and
caffeine on mood, sleep, and healthrelated quality of life. Journal of Caffeine
Research, 7(2), 59-70.
https://doi.org/10.1089/jcr.2016.0023
O’Neill, C. E., Newsom, R. J., Stafford, J.,
Scott, T., Archuleta, S., Levis, S. C.,
Spencer, R. L., Campeau, S., & Bachtell,
R. K. (2016). Adolescent caffeine
consumption increases adulthood
anxiety-related behavior and modifies
neuroendocrine signaling.
Psychoneuroendocrinology, 67, 40–50.
https://doi.org/10.1016/j.psyneuen.2016.0
1.030

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Table 1
Correlations for Study Variables

Variables

Serotonin Decrease
& Caffeine Increase
Anxiety Increase &
Caffeine Increase
Depression Increase
& Caffeine Increase

Participant
#1

Participant
#2

Pooled raw
data

r

n

r

n

r

n

Pooled
standardized
data
r
n

-0.05

16

-0.20

16

-0.08

32

-0.13

32

-0.10

16

0.24

16

0.04

32

0.07

32

-0.02

16

0.23

16

0.04

32

0.10

32

* p < .05.

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Table 2
Descriptive Statistics for Insomnia Scores Across Different Caffeine Intake Conditions
Condition

Statistic

Caffeinated Coffee

M

Participant
#1
16.45*

SD

3.45

n

11

Decaffeinated

M

5.49

Coffee

SD

3.89

n

10

Note. M, SD, and n, represent mean, standard deviation, and sample size, respectively. Insomnia
was rated on a scale of 1-24, where higher score = more insomnia. * p < .05 for comparison of
Caffeinated Coffee condition with its respective Decaffeinated Coffee condition.

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Figure 1
Association Between Caffeine and Insomnia Scores Using Pooled Raw Data

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers. Higher insomnia scores
are interpreted to mean lower serotonin levels.

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Figure 2
Association Between Caffeine and Insomnia Scores Using Pooled Standardized Data
2

Serotonin Level (z-score)

1.5

-2

1
0.5
0
-1.5

-1

-0.5

-0.5

0

0.5

1

1.5

2

2.5

3

-1
-1.5
-2
-2.5
Daily caffeine intake (z-score)

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers. Higher insomnia scores
are interpreted to mean lower serotonin levels.

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Figure 3
Association Between Caffeine and Anxiety Using Pooled Raw Data

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers.

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Figure 4
Association Between Caffeine and Anxiety Using Pooled Standardized Data

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers.

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Figure 5
Association Between Caffeine and Depression Using Pooled Raw Data

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers.

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Figure 6
Association Between Caffeine and Depression Using Pooled Standardized Data
3
2.5

Depression (z-score)

2

-2

1.5
1
0.5

0
-1.5

-1

-0.5

-0.5

0

0.5

1

1.5

2

2.5

3

-1
-1.5
-2
Daily Caffeine Intake (z-score)

Notes. Marker colour differentiates participants: red = participant #1, orange = participant #2.
Some data might not be visible in the figure due to overlapping markers.

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Figure 7

Serotonin Level (Athens Insomnia Scale)
(Scale 1-24; Higher Score = More Insomnia)

Average Insomnia Scores Across Different Caffeine Intake Conditions Using Raw Data
25

20

15

10

5

0
Caffeinated Coffee

Decaffeinated Coffee
Daily Caffeine Intake

Notes. Insomnia scores are shown for caffeinated coffee and decaffeinated coffee conditions.
Errors bars show ± 95% confidence levels. Overlapping scatterplot show individual data points.

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Figure 8

Serotonin Level (Athens Insomnia Scale) (zscore)

Average Insomnia Scores Across Different Caffeine Intake Conditions Using Standardized Data
2
1.5
1
0.5
0
-0.5
-1
-1.5
-2
Caffeinated Coffee

Decaffeinated Coffee
Daily Caffeine Intake

Notes. Insomnia scores are shown for caffeinated coffee and decaffeinated coffee conditions.
Errors bars show ± 95% confidence levels. Overlapping scatterplot show individual data points.

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Appendix A

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Appendix B

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Appendix C
ATHENS INSOMNIA SCALE
This scale is intended to record your own assessment of any sleep difficulty you might have
experienced. Please, check (by circling the appropriate number) the items below to indicate
your estimate of any difficulty.

Sleep factors

Sleep induction

Athens insomnia scale

0: No

1: Slightly

2: Markedly

3: Very delayed or

problem

delayed

delayed

did not sleep at all

Awakenings

0: No

1: Minor

2: Considerable

3: Serious problem

during the night

problem

problem

problem

or did not sleep at
all

Final awakening 0: Not

1: A little

2: Markedly

3: Much earlier or

earlier

earlier

did not sleep at all

0: Sufficient 1: Slightly

2: Markedly

3: Very insufficient

insufficient

insufficient

or did not sleep at

earlier

Total sleep
duration

all

Sleep quality

0:

1: Slightly

Satisfactory unsatisfactory

2: Markedly

3: Very

unsatisfactory

unsatisfactory or
did not sleep at all

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Well-being

0: Normal

during the day

Functioning

0: Normal

capacity during

1: Slightly

2: Markedly

decreased

decreased

1: Slightly

2: Markedly

decreased

decreased

1: Mild

2: Considerable

3: Very decreased

3: Very decreased

the day

Sleepiness

0: None

3: Intense

during the day

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