The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood

Hangover research often records the presence and severity of symptoms experienced the day after heavy alcohol consumption. However, usually no information is gathered on the impact of experiencing these symptoms on mood, cognition, and physical activities. An online survey was held among Dutch students, aged 18–30 years, who recently had a hangover. Overall hangover severity (i.e., a single 1-item rating) and the severity of 22 individual symptoms were rated on an 11-point scale ranging from 0 (absent) to 10 (extreme). In addition, for each symptom, participants were asked to rate their respective negative impact on (a) cognitive functioning, (b) physical functioning, and (c) mood, on a 6-point Likert scale ranging from 0 (no impact) to 5 (extreme). N = 1837 subjects completed the survey. The mean (SD) overall (1-item) hangover severity score was 6.1 (1.9). Sleepiness, being tired, thirst, and concentration problems were the most frequently reported hangover symptoms. These symptoms also reached the highest severity scores (ranging from 6.3 to 7.0). The 4 symptoms with the biggest combined impact on mood, and cognitive and physical functioning were being tired, sleepiness, headache, and concentration problems. In conclusion, whereas severity and impact scores usually correspond well, some frequently reported symptoms with moderate to high severity scores had little impact on mood, and cognitive and physical functioning (i.e., reduced appetite, regret, and thirst)

Development of a definition for the alcohol hangover: Consumer descriptions and expert consensus

Up to now, there is no adequate definition of the alcohol hangover. The purpose of the current study was to develop a useful definition, and consensus among those who will use it in scientific publications. A survey was conducted among N=1099 social drinkers who recently had a hangover. They were asked to provide their definition of the alcohol hangover. Text mining and content analysis revealed 3 potential definitions. These were submitted to members of the Alcohol Hangover Research Group, who were asked to give their expert opinion on the proposed definitions. Taking into account their comments and suggestions, the following definition for the alcohol hangover was formulated: “The alcohol hangover refers to the combination of mental and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration approaches zero.

Differences in Next-Day Adverse Effects and Impact on Mood of an Evening of Heavy Alcohol Consumption between Hangover-Sensitive Drinkers and Hangover-Resistant Drinkers

The combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero, are collectively referred to as the alcohol hangover. Previous research revealed that 10 to 20% of drinkers claim not to experience next-day hangovers. Past studies were usually limited to single timepoint assessments. The aim of the current semi-naturalistic study was to compare the next-day effects of an evening of alcohol consumption of self-reported hangover-resistant drinkers (n = 14) with those of a group of self-reported hangover-sensitive drinkers (n = 15) at hourly timepoint throughout the day (09:30 until 15:30). Assessments of 23 hangover symptoms, mood (Profiles of Mood States-Short Form), and daytime sleepiness (Karolinska Sleepiness Scale) were made hourly after both an alcohol day and an alcohol-free control day. Additional morning assessments were made for mood (State-Trait Anxiety Inventory-Y, Beck’s Depression Inventory-II), risk-taking behavior (RT-18), past night sleep (Groningen Sleep Quality Scale), alcohol consumption, and activities during the test days. No significant differences were found regarding the amount of alcohol consumed and the total sleep time of the two groups. The hangover-sensitive group reported having a hangover as well as the presence of a variety of hangover-related symptoms, which were most severe in the morning and then gradually decreased during the day. The most frequently reported and most severe symptoms were sleepiness and fatigue, concentration problems, and headache. In contrast, the hangover-resistant group reported the absence of a hangover and the presence and severity of next-day symptoms did not significantly differ from the control day, except for increased fatigue and reduced vigor. The next-day effects on sleepiness-related complaints and vigor were significantly more pronounced among hangover-sensitive drinkers compared to hangover-resistant drinkers. In conclusion, contrary to hangover-resistant drinkers, hangover-sensitive drinkers report a variety of hangover symptoms that gradually ease during the day, but are still present in the afternoon

Susceptibility to alcohol hangovers: Not just a matter of being resilient

Introduction: Although most drinkers have experienced a hangover the day following heavy alcohol consumption, a minority claims to be hangover resistant despite consuming the same large quantities of alcohol as those reporting alcohol hangover. The aim of the current study was to examine if susceptibility to experiencing hangovers is related to a drinker's interpretation of wellbeing and psychological assets to bounce back. Methods: A survey was conducted among 2295 Dutch students assessing their past month alcohol consumption patterns, and measuring mental resilience and wellbeing. Estimated peak blood alcohol concentration (e-pBAC) for their heaviest drinking occasion in the past month was computed for each participant. Data from participants who reported a past month hangover, i.e. hangover sensitive drinkers, were compared with hangover resistant drinkers. The analyses were conducted for (a) all participants reaching an e-pBAC ≥ 0.11% (N = 986, of which 24.6% claimed to be hangover resistant) and (b) participants reaching an e-pBAC ≥ 0.18% (N = 480, of which 16.7% claimed to be hangover resistant). Results: For both e-pBAC cut-off values, no significant differences between hangover sensitive and hangover resistant drinkers were found for mental resilience and wellbeing. Conclusion: The current findings suggest that having a hangover is not simply an expression of poor psychological coping with the next-day consequences of heavy alcohol consumption

An evening of alcohol consumption negatively impacts next-day immune fitness in both hangover-sensitive drinkers and hangover-resistant drinkers

Background: Survey research found poorer baseline immune fitness for self-reported hangover-sensitive drinkers compared to hangover-resistant drinkers. However, up to now a limited number of clinical studies revealed mixed results regarding the relationship between the concentrations of biomarkers of systemic inflammation in blood or saliva with hangover severity, and could not differentiate between hangover-sensitive drinkers and hangover-resistant drinkers. The aim of this study was to assess immune fitness and saliva biomarkers of systemic inflammation at multiple timepoints following an alcohol day and alcohol-free control day. Methods: The study had a semi-naturalistic design. In the evening before the test days, participants were not supervised. They could drink ad libitum drinking on the alcohol test day and refrained from drinking alcohol on the control day. Activities and behaviors on the alcohol and control day were reported the follow morning. On both test days, from 09:30 to 15:30, hourly assessments of immune fitness (single-item scale) and overall hangover severity (single-item scale) were made and saliva samples were collected for biomarker assessments. Results: N = 14 hangover-resistant drinkers and n = 15 hangover-sensitive drinkers participated in the study. The amount of alcohol consumed on the alcohol day did not significantly differ between the hangover-resistant group (mean (SD) of 13.5 (7.9) alcoholic drinks) and the hangover-sensitive group (mean (SD) of 12.4 (4.4) alcoholic drinks). All hangover-sensitive drinkers reported having a hangover following the alcohol day (overall hangover severity score 6.1 (on a 0–10 scale) at 09:30, gradually decreasing to 3.3 at 15:30), whereas the hangover-resistant drinkers reported no hangover. On the control day, immune fitness of the hangover-sensitive group was significantly poorer than the hangover-resistant group. On the alcohol day, both groups showed a significant reduction in immune fitness. The effect was evident throughout the day, but significantly more pronounced in the hangover-sensitive group than the hangover-resistant group. No significant differences between the groups were found at any time point on the two test days for saliva concentrations of Interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α. Conclusions: Whereas hangover-sensitive drinkers reported a hangover following an alcohol day and hangover-resistant drinkers did not, both groups reported significantly reduced immune fitness throughout the day. However, the reduction in immune fitness among hangover-sensitive drinkers was significantly more pronounced in comparison to the hangover-resistant group

Proceeding of the 9th alcohol hangover research group meeting

Background: Alcohol hangover is a common occurrence among individuals who have experienced an episode of heavy alcohol consumption the previous night. Until now defined as the general feeling of misery that develops once the Blood Alcohol Concentration approaches zero. Despite its prevalence and several related adverse consequences, insufficient research has been conducted with regards to this matter and further understanding of the pathology of alcohol hangover is necessary. During the 9th Alcohol Hangover Research Group meeting, held on April 29th 2017, Utrecht, The Netherlands, numerous aspects of alcohol hangover were presented and many advances with regards to determinants, biological and cognitive consequences and potential treatment have been presented. Conclusion: Precisely, a definition of alcohol hangover has been established and wider understandings of biological and cognitive effects, alcohol metabolism, immune functioning and potential treatment of alcohol hangover were presented and discussed. Further research and development are necessary to attain a wider understanding of the pathology of alcohol hangover

Sensitivity to Experiencing Alcohol Hangovers: Reconsideration of the 0.11% Blood Alcohol Concentration (BAC) Threshold for Having a Hangover

The 2010 Alcohol Hangover Research Group consensus paper defined a cutoff blood alcohol concentration (BAC) of 0.11% as a toxicological threshold indicating that sufficient alcohol had been consumed to develop a hangover. The cutoff was based on previous research and applied mostly in studies comprising student samples. Previously, we showed that sensitivity to hangovers depends on (estimated) BAC during acute intoxication, with a greater percentage of drinkers reporting hangovers at higher BAC levels. However, a substantial number of participants also reported hangovers at comparatively lower BAC levels. This calls the suitability of the 0.11% threshold into question. Recent research has shown that subjective intoxication, i.e., the level of severity of reported drunkenness, and not BAC, is the most important determinant of hangover severity. Non-student samples often have a much lower alcohol intake compared to student samples, and overall BACs often remain below 0.11%. Despite these lower BACs, many non-student participants report having a hangover, especially when their subjective intoxication levels are high. This may be the case when alcohol consumption on the drinking occasion that results in a hangover significantly exceeds their “normal” drinking level, irrespective of whether they meet the 0.11% threshold in any of these conditions. Whereas consumers may have relative tolerance to the adverse effects at their “regular” drinking level, considerably higher alcohol intake—irrespective of the absolute amount—may consequentially result in a next-day hangover. Taken together, these findings suggest that the 0.11% threshold value as a criterion for having a hangover should be abandoned

Op zoek naar de biomarkers van de kater

De alcoholkater wordt gedefinieerd als de combinatie van mentale en fysieke symptomen die ervaren worden de dag na een stevige drinksessie, die start wanneer de bloedalcoholconcentratie de nulwaarde nadert. Dit artikel betreft een naturalistisch opgezet onderzoek naar de samenhang tussen de ernst van de alcoholkater en mogelijke biomarkers voor een alcoholkater, namelijk de urineconcentraties van ethanol, methanol, ethylglucuronide (EtG) en ethylsulfaat (EtS). Aan dit onderzoek deden 36 gezonde sociale drinkers mee (18 katersensitieve en 18 katerresistente drinkers). Van alle deelnemers werden op een postalcoholdag en op de controledag de urineconcentraties van ethanol, methanol, EtG en EtS bepaald. Deelnemers konden zelf hun controledag en postalcoholdag bepalen, evenals de hoeveelheid alcohol die zij consumeerden. Vervolgens is de correlatie tussen de urineconcentratie en de ernst van de alcoholkater berekend en gescoord op een schaal van 0 (afwezig) tot 10 (extreem erg). De correlatie tussen de ernst van de alcoholkater en de urineconcentraties waren niet significant. Wel correleerden de ethanol-urineconcentraties significant met de ernst van de alcoholkater. Verder onderzoek is nodig naar de pathologie van de alcoholkater en mogelijke biomarkers die significant correleren met de ernst van de kater

Op zoek naar de biomarkers van de kater

De alcoholkater wordt gedefinieerd als de combinatie van mentale en fysieke symptomen die ervaren worden de dag na een stevige drinksessie, die start wanneer de bloedalcoholconcentratie de nulwaarde nadert. Dit artikel betreft een naturalistisch opgezet onderzoek naar de samenhang tussen de ernst van de alcoholkater en mogelijke biomarkers voor een alcoholkater, namelijk de urineconcentraties van ethanol, methanol, ethylglucuronide (EtG) en ethylsulfaat (EtS). Aan dit onderzoek deden 36 gezonde sociale drinkers mee (18 katersensitieve en 18 katerresistente drinkers). Van alle deelnemers werden op een postalcoholdag en op de controledag de urineconcentraties van ethanol, methanol, EtG en EtS bepaald. Deelnemers konden zelf hun controledag en postalcoholdag bepalen, evenals de hoeveelheid alcohol die zij consumeerden. Vervolgens is de correlatie tussen de urineconcentratie en de ernst van de alcoholkater berekend en gescoord op een schaal van 0 (afwezig) tot 10 (extreem erg). De correlatie tussen de ernst van de alcoholkater en de urineconcentraties waren niet significant. Wel correleerden de ethanol-urineconcentraties significant met de ernst van de alcoholkater. Verder onderzoek is nodig naar de pathologie van de alcoholkater en mogelijke biomarkers die significant correleren met de ernst van de kater

Attitudes towards Addressing Medical Absenteeism of Students: A Qualitative Study among Principals and Special Education Needs Coordinators in Dutch Secondary Schools

BACKGROUND:Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools' perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. METHODS:A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. FINDINGS:The main reasons for schools to address medical absenteeism were their concerns about students' well-being and future prospects and their wish to share these concerns with students' parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers' dialogue about medical absence with students and their parents, teachers' follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. CONCLUSIONS:MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools' need to address medical absenteeism by providing a clear framework, an approach from concern rather than control, and socio-medical expertise through the collaboration with YHCPs. MASS can support schools to maximize the number of students graduating and to improve parental involvement in school. These outcomes may help to put the subject of addressing medical absenteeism on the agenda of all schools, and contribute to prioritization, support adoption and secure sustainable implementation and dissemination of MASS