question: If affected by caffeine differently, are there other ways to stay awake without caffeine?
comment: If it isn't already in your (or the doctor's) plan - I highly recommend asking to have your thyroid hormone levels checked. Underactive thyroids can cause so many random symptoms to appear and be different from one person to the next. Caffeine is often recommended to be reduced or eliminated if the thyroid is abnormal. You obviously have adverse reactions to caffeine, so definitely it's something that your body doesn't process well. Vitamin B and vitamin D supplements can be helpful, as well as a balanced diet: carbs + protein + moderate fats. Also look into aromatherapy. Certain essential oils diffused nearby can help keep you alert but calm at the same time. Might ease the migraines too.
passages: Though caffeine can be shown to decrease the quality of sleep, there is no evidence that caffeine affects all people the same way. In fact, some people report no sleep problems despite regularly consuming caffeine. Regular intake of caffeine may be normal for a person so it is understandable how they may still get satisfactory sleep. This finding shows that caffeine interferes with a modulatory mechanism in sleep regulation rather than a fundamental sleep regulatory brain circuit. Ultimately, regular sleep habits are important in overall quality and timing of sleep.
   Caffeine is a central nervous system stimulant that reduces fatigue and drowsiness. At normal doses, caffeine has variable effects on learning and memory, but it generally improves reaction time, wakefulness, concentration, and motor coordination. The amount of caffeine needed to produce these effects varies from person to person, depending on body size and degree of tolerance. The desired effects arise approximately one hour after consumption, and the desired effects of a moderate dose usually subside after about three or four hours.
   Tolerance to the effects of caffeine occurs for caffeine induced elevations in blood pressure and the subjective feelings of nervousness. Sensitization, the process whereby effects become more prominent with use, occurs for positive effects such as feelings of alertness and well being. Tolerance varies for daily, regular caffeine users and high caffeine users. High doses of caffeine (750 to 1200 mg/day spread throughout the day) have been shown to produce complete tolerance to some, but not all of the effects of caffeine. Doses as low as 100 mg/day, such as a 6 oz cup of coffee or two to three 12 oz servings of caffeinated soft-drink, may continue to cause sleep disruption, among other intolerances. Non-regular caffeine users have the least caffeine tolerance for sleep disruption. Some coffee drinkers develop tolerance to its undesired sleep-disrupting effects, but others apparently do not.
   Section::::Treatments/countermeasures.:Caffeine.
  
  Caffeine is a xanthine derivative that can cross the blood-brain barrier. The caffeine present in coffee or tea exerts its stimulating action by blocking adenosine receptors in the brain. By antagonizing the adenosine receptors caffeine limits the effects of adenosine buildup in the brain and increases alertness and attentiveness. Previous research has shown that coupled with a short nap, consuming caffeine prior to the nap can alleviate the effects of sleep inertia. Nonetheless, individual degree of consumption and tolerance to caffeine may be responsible for variation in its efficacy to reduce sleep inertia symptoms.
  
  Section::::Treatments/countermeasures.:Light.
   The specific criteria for this disorder in the fourth version of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) include that there must be a significant inability to sleep which is caused entirely by the physiological effects of caffeine as proven by an examination; if sleeping issues can be accounted for due to a breathing-related sleep disorder, narcolepsy, a circadian rhythm sleep disorder or a mental disorder, then caffeine-induced sleep disorder is not the cause. This condition causes a notable impairment in functioning in sufferers.
  
  Overconsumption:
   Although the maximum daily consumption of caffeine varies with consideration of couple of aspects such as gender, age, race, physical activity and smoking, excessive ingestion of caffeine can lead to a state of intoxication. This period of intoxication is characterized by restlessness, agitation, excitement, rambling thought or speech, and even insomnia. Even doses of caffeine relating to just one cup of coffee can increase sleep latency and decrease the quality of sleep especially in non-REM deep sleep. A dose of caffeine taken in the morning can have these effects the following night, so one of the main practices of sleep hygiene a person can do is to cease the consumption of caffeine.
   There is also existing evidence that reflects on the duration of the caffeine avoidance period in relation to the significance of the withdrawal symptoms. In the study previously mentioned, the strongest withdrawal effects were seen among participants who underwent a 13-hour avoidance period, followed by the 7-day avoidance group. This would imply that memory effects would be at their strongest around the 13-hour mark and would continue to be affected for the following days. Memory would not be affected, however, within the first few hours. This appears valid considering most daily caffeine users need to consume caffeine shortly after awaking from sleep. For example, coffee drinkers were given either caffeine or a placebo after overnight caffeine abstinence. The study showed that regular coffee drinkers became less alert and more anxious than non-coffee drinkers when receiving the placebo. To coincide with this finding, another study in 2001 found a dose-related improvement in cognitive performance for daily caffeine users. This means that coffee drinkers experience the same positive effects every day they consume coffee.
   Caffeine-induced sleep disorder is a psychiatric disorder that results from overconsumption of the stimulant caffeine. "When caffeine is consumed immediately before bedtime or continuously throughout the day, sleep onset may be delayed, total sleep time reduced, normal stages of sleep altered, and the quality of sleep decreased." Caffeine reduces slow-wave sleep in the early part of the sleep cycle and can reduce rapid eye movement sleep later in the cycle. Caffeine increases episodes of wakefulness, and high doses in the late evening can increase sleep onset latency. In elderly people, there is an association between use of medication containing caffeine and difficulty in falling asleep.
   Studies have demonstrated that people who take in a minimum of 100 mg of caffeine per day (about the amount in one cup of coffee) can acquire a physical dependence that would trigger withdrawal symptoms that include headaches, muscle pain and stiffness, lethargy, nausea, vomiting, depressed mood, and marked irritability. Professor Roland Griffiths, a professor of neurology at Johns Hopkins in Baltimore strongly believes that caffeine withdrawal should be classified as a psychological disorder. His research suggested that withdrawals affects 50% of habitual coffee drinkers, beginning within 12-24 hours after cessation of caffeine intake, and peaking in 20-48 hours, lasting as long as 9 days. Continued exposure to caffeine leads the body to create more adenosine receptors in the central nervous system which makes it more sensitive to the effects of adenosine in two ways: It reduces the stimulatory effects of caffeine by increasing tolerance, and it increases the withdrawal symptoms of caffeine as the body becomes more sensitive to the effects of adenosine once caffeine intake stops. Caffeine tolerance develops very quickly. Tolerance to the sleep disruption effects of caffeine were seen after consumption of 400 mg of caffeine 3 times a day for 7 days, whereas complete tolerance was observed after consumption of 300 mg taken 3 times a day for 18 days.
   Caffeine increases intraocular pressure in those with glaucoma but does not appear to affect normal individuals.
  
  Section::::Overdose.
  
  Consumption of per day is associated with a condition known as "caffeinism." Caffeinism usually combines caffeine dependency with a wide range of unpleasant symptoms including nervousness, irritability, restlessness, insomnia, headaches, and palpitations after caffeine use.
   Section::::Treatment.
  
  Treatment of mild caffeine intoxication is directed toward symptom relief; severe intoxication may require peritoneal dialysis, hemodialysis, or hemofiltration. Control of caffeine intake requires awareness of the caffeine content of caffeinated beverages, over-the-counter drugs, and other sources of caffeine in the diet. Such information is not easy to obtain. The content of brewed beverages such as coffee and tea varies greatly based on the method of preparation.
   Caffeine's mechanism of action is somewhat different from that of cocaine and the substituted amphetamines; caffeine blocks adenosine receptors A and A2A. Adenosine is a by-product of cellular activity, and stimulation of adenosine receptors produces feelings of tiredness and the need to sleep. Caffeine's ability to block these receptors means the levels of the body's natural stimulants, dopamine and norepinephrine, continue at higher levels.
  
  The "Diagnostic and Statistical Manual of Mental Disorders" describes four caffeine-related disorders including intoxication, withdrawal, anxiety, and sleep.
  
  Section::::Dependence.
   There are four caffeine-induced psychiatric disorders recognized by the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition": caffeine intoxication, caffeine-induced anxiety disorder, caffeine-induced sleep disorder, and caffeine-related disorder not otherwise specified (NOS).
  
  There are also risks associated with consuming caffeine during pregnancy, with studies having shown more than 200 mg of caffeine per day can result in miscarriage.
  
  Section::::Naturally low-caffeine coffees.
   Caffeine can delay or prevent sleep and improves task performance during sleep deprivation. Shift workers who use caffeine make fewer mistakes due to drowsiness.
  
  A systematic review and meta-analysis from 2014 found that concurrent caffeine and -theanine use has synergistic psychoactive effects that promote alertness, attention, and task switching; these effects are most pronounced during the first hour post-dose.
  
  Section::::Use.:Enhancing performance.:Physical.
   Mild physical dependence can result from excessive caffeine intake. Caffeine addiction, or a pathological and compulsive form of use, has not been documented in humans.
   Most microsleeps are not clinically significant, however. Individuals who feel sleepy and wish to maintain alertness often consume over-the-counter stimulants such as caffeine in coffee. More specifically, it has been shown that high-frequency low-dose caffeine intake is effective at countering poor work performance effects due to extended wakefulness, confirming the hypothesis that adenosine is a mediator of performance decrements associated with extended wakefulness. Other stimulants that could decrease microsleep frequency include Adderall, amphetamine, cocaine, and tobacco.
  
  Section::::In popular culture.
   Mazindol is a stimulant similar to amphetamines that "has been shown to be effective in treating hypersomnia in narcoleptics." However, it is not currently approved in the US.
  
  Caffeine is one of the safer nondopaminergic wake-promoting compounds. It is widely used but "has intolerable side effects at high doses (including cardiovascular), and it is generally not efficient enough for patients with hypersomnia or narcolepsy."
  
  Section::::Management.:Wakefulness promoting medications.
   To attempt to abruptly quit all consumption of caffeine-containing products from the diet is not recommended, because the person could suffer from the resulting symptoms of caffeine withdrawal, including headache, fatigue, and difficulty concentrating, can be so
  
  unpleasant that this approach probably will fail. It is recommended that the person performs a gradual reductions in caffeine use to avoid withdrawal.
  
  Section::::Epidemiology.
  
  Little is known about the prevalence of caffeinism in the general population. Although most people are familiar with the disorder, it probably remains underdiagnosed, because patients are rarely questioned about the use of caffeine.
   Short-term memory has been thought to be influenced differently throughout the day when caffeine has been ingested; in the morning, STM performance will be different from at the end of the day. As the effects of caffeine wear off, there would be some effect on STM. Three groups of caffeine intake (low, medium, and high) were compared during four daytime hours (01:00, 07:00, 13:00, 19:00). People with low caffeine intake have a decreased performance later in the day, compared to moderate and a high-level caffeine intake. Results are interesting but do not conclusively determine that caffeine impairs or improves short-term memory compared to a control group.
   BULLET::::4. periods of inexhaustibility, and
  
  BULLET::::5. psychomotor agitation,
  
  BULLET::::6. anorexia (loss of appetite).
  
  The symptoms of caffeine intoxication are comparable to the symptoms of overdoses of other stimulants. In cases of much larger overdoses, mania, depression, lapses in judgment, disorientation, disinhibition, delusions, weight loss, loss of appetite, hallucinations, or psychosis may occur.
   Tablets offer several advantages over coffee, tea, and other caffeinated beverages, including convenience, known dosage, and avoidance of concomitant intake of sugar, acids, and fluids. Manufacturers of caffeine tablets claim that using caffeine of pharmaceutical quality improves mental alertness. These tablets are commonly used by students studying for their exams and by people who work or drive for long hours.
  
  Section::::Products.:Other oral products.
   Some of these processes include wakefulness, stimulation, and mood and cognition enhancement. Low doses can result in psychological effects of "mild euphoria, alertness, and enhanced cognitive performance"; higher doses produce physiological side effects of nausea, anxiety, trembling, and jitteriness.
  
  There are individuals who are prone to caffeine's anxiogenic effects whilst others are susceptible to its caffeine-induced sleep disturbances and insomnia. Studies with twins have shown that genetics influence individual differences in response to caffeine. Homozygous twins have been found to react in more consistent ways to the caffeine than heterozygous twins.
  
  Section::::Behavioral effects.
   According to the Diagnostic and Statistical Manual of Mental Disorders, caffeine overdose can result in a state of excessive stimulation of the central nervous system and the essential feature of Caffeine Intoxication is the recent consumption of caffeine. This diagnosis requires the presence of at least five signs or symptoms, from a list of 12, that develop during or shortly after
  
  caffeine use. This syndrome regularly happens when a person ingested large amounts of caffeine from any source (e.g., more than 400–500 mg at a time).
   Caffeine is also an ingredient of several medications, many of them over-the-counter and prescription drugs. The consensus is to consider caffeine a drug with pharmacological effects acting throughout the body.
  
  Section::::Signs and symptoms.
   Death can occur when a person had a caffeine overdose. The LD of caffeine in humans is dependent on individual sensitivity, but is estimated to be 150–200 milligrams per kilogram of body mass (75–100 cups of coffee for a 70 kilogram adult). A number of fatalities have been caused by overdoses of readily available powdered caffeine supplements, for which the estimated lethal amount is less than a tablespoon. The lethal dose is lower in individuals whose ability to metabolize caffeine is impaired due to genetics or chronic liver disease A death was reported in a man with liver cirrhosis who overdosed on caffeinated mints.
  