Two cups of coffee sitting back to back. One is joyful and spilling coffee out the top while the other is wearing a face mask to sleep.

MS and Coffee: My Uneasy Alliance

I love coffee. How could I not? It’s as ubiquitous as the rain here in Seattle. It’s warming, smells heavenly, and serves as a welcome companion to some of my favorite things: meetups with friends, a savory breakfast, cooking shows on Saturday mornings, or the occasional all-night writing jag.

How I like my one-a-day coffee

Honestly, I like brewed coffee if it's fairly strong. This, in no way, describes how it’s brewed in my house, unfortunately...so I opt for a certain brand of instant micro-grind to satisfy my one-a-day habit. I add soy creamer, sweetener, maybe a dash of cinnamon or cardamom. When I'm out and about, it's espresso drinks for the win. Come to think of it, so are coffee shakes and iced coffee beverages.

Despite this devotion to the brewed bean, however, my alliance with it remains an uneasy one.

Coffee and sleep are not besties

Even before I became a sleep technologist and sleep health educator, I was wary of my cup of Joe even as I order it at the local diner counter.

This is one of my all-time favorite things to do in life: Go to a diner, drink coffee—usually with a slice of cherry pie—and read a magazine. I know, it’s a Twin Peaks cliché, but I can’t help myself.

I have never been capable of drinking cup after cup of coffee, though. Not even during college. Instead, I’m given to fits of jitters even after just one ordinary cup from the Bunn-O-Matic.

Sleep hygiene tip: limit caffeine after lunch

Now that I counsel people on ways to improve their sleep hygiene, I always have to do the hard job of telling them they must limit their caffeine after lunch.

I don’t take joy in this. I understand the need— craving, even— for a cup of roasted liquid goodness during the mid-afternoon slump, even as I know that caffeine’s stimulation half-life measures at five hours.

Caffeine's stimulation half-life

What does this mean? In five hours’ time, half of the caffeine will be metabolized by your system. However, the other half continues to float around in your bloodstream until it’s fully metabolized, and that could be several hours more.

In short: That 3pm cuppa may still be with you after midnight. Me? I prefer to be asleep by then. My MS brain demands it.

Caffeine and MS: Mixed company

Another problem I’ve had with coffee — its compelling influence over certain body functions. Caffeine and MS don't always play well together.

MS already messes with my daily bathroom habits. It’s cyclical: the roller coaster of constipation this week, then diarrhea the next week — then it starts all over again. Coffee also amplifies the urgency to void. These digestive issues are certainly among my least favorite MS symptoms.

Can coffee help with MS fatigue?

And you’d think the caffeine in coffee would be an easy, helpful, and tasty solution to MS fatigue, my biggest symptom.

However, it doesn’t do much for that. If anything, I feel the caffeine "crash and burn" that much more. Trust me, I've tried.

The bright side

However, some research seems to indicate that caffeine can be useful for some people with MS, especially those who drink a lot of it.

Six studies reviewed in Frontiers in Nutrition in 2018 highlighted the impact of coffee and caffeine on people with MS.1

The researchers found:

  • A significant association between high amounts of coffee consumption and a decreased risk for MS
  • Coffee consumption can have a positive effect on disease course and progression in those with relapsing-remitting disease
  • Coffee seems to be neuroprotective when used to treat laboratory mice with the animal equivalent of MS known as EAE (experimental autoimmune encephalomyelitis)2

The first finding is irrelevant to those who already have MS, unfortunately. The other two are encouraging, however.

This research reports benefits from drinking coffee

Meanwhile, this research supports the quaffing of several cups of coffee per day, something that'll never be an option for me. Maybe it’ll work for you?

Another benefit to enjoying coffee may become apparent if you need to undergo a spinal tap in your quest to confirm an MS diagnosis.

I don't live near a hospital at all, so when I developed a major spinal headache two days after getting my spinal tap, it wasn't possible to quickly receive a blood patch for relief.3

Caffeine relieved by spinal headache

My refuge instead? Three 20-ounce cups of Americano espresso consumed over two hours.4 The resulting caffeine blast made it possible for me to shirk my pain and go to work that night at the sleep clinic, for which I'm ever so grateful!

Even if I can't drink a lot of coffee, and have to refuse it after lunch, I'll stick with my morning cup of comfort. It's so much better than none at all, a daily ritual I would miss. And really...who with MS doesn’t need a little extra comfort these days?

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