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Comment by jonpaul | Hacker News Reader

I went to the ER (https://twitter.com/jprichardson/status/522084579906052096) about 2.5 weeks ago because I didn't get enough sleep and drank way too much caffeine. My body just collapsed.

From October 5th through October 11th, I actively rejected sleep (2 - 4 hours of sleep) and took in quantities of caffeine ranging from 1.5 g to 2 g. (A cup of coffee has approx 100 mg and a strong energy drink has about 250 mg). I was preparing for launch of my product and subsequent YC application. On Saturday morning, October 11th, I had massive chest pains and I collapsed. Fortunately, everything is alright with my heart. Overall though, I felt incredibly stupid about my actions.

As hackers and entrepreneurs, it's really easy to fall into the trap of your launch being the most important thing in the world. It's not. You need to be healthy, as business is a marathon and you'll be running for awhile.

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> A cup of coffee has approx 100 mg and a strong energy drink has about 250 mg

That's a _very_ strong energy drink too, most are in the 140-160mg range in my experience. Less caffeine than a large at a major coffee joint.

Holy crap though, that's crazy. Over what time period did you consume that much caffeine? Do you mean daily or over the full 5th-11th period?

That caffeine intake was daily.

My poison of choice was Rockstar Pure Zero - Mango Orange Passion Fruit. They originally launched with 160 mg per can, but bumped it to 240 mg. http://www.caffeineinformer.com/caffeine-content/rockstar-pu...

Like I said, not one of my brighter moments - I was just willing to do whatever it took to launch. In hindsight, not worth it at all.

As someone who experiments with nootropics, I highly recommend modafinil over caffeine for sprints like that (up to 36 hours of wakefulness at a time, no jittery feeling, etc). You should not do it for any appreciable amount of time though. See https://reddit.com/r/nootropics for more info.

Modafinil is much more expensive, harder to get, and not everybody responds to it.

I once watched three engineers take Modafinil for an all-nighter. It was their first time taking it.

By about midnight none of the engineers felt any different. One of them decided it wasn't doing anything and went to bed. The other two decided to keep hacking until they got tired.

Come morning the two guys who kept hacking were still hacking. The third guy said he slept soundly. The two guys who kept working said that, while the Modafinil never made them feel different, neither were they particularly sleepy. Exhausted, yes, but not sleepy.

The guy who decided to go to sleep used Modafinil after that and it worked as advertised. He just needed to realize that it wasn't going to make him feel stimulated.

I know that at least one paper shows efficacy dependent on certain alleles. But AFAIK none say that it doesn't work at all. And the majority of people have the alleles where Modafinil works well.

Compared with OD-ing on caffeine or other stimulants, I'd say Modafinil is the better choice. There's no substitute for sleep, and unlike normal stimulants you can usually deliberately go to sleep even after taking a full dose of Modafinl. Which means you can use your time more efficiently during a marathon and still get some proper rest.

Modafinil, while a bit more expensive than caffeine in pill form, is easily available online without a prescription.

You're correct.

There's lot of confusion here over beverage sizes.

240mg in a 16oz/473ml can. It also seems to have been reduced back to 160mg.

Even at 240mg it's equivalent to or less than a cup of medium strength regular coffee. And not close to Espresso.

The problem is, it's much easier to drink down sugary beverages than coffee(especially hot).

> 240mg in a 16oz/473ml can. It also seems to have been reduced back to 160mg.

A few of the "Pure Zero" variants seem to have (or had) a ludicrous quantity of caffeine. If I have any complaint (well, other than that a 16oz can doesn't have 2 servings worth!) it's that I don't know that the caffeine should really differ between them; one might not expect what seems to be simply a different flavor to differ markedly. My solution to that has been to read the ingredients.

> Even at 240mg it's equivalent to or less than a cup of medium strength regular coffee. And not close to Espresso.

Coffee varies but generally speaking if one goes by the "serving size" on an energy drink it's typically on par with coffee: http://www.reddit.com/r/askscience/comments/ip9ia/ive_been_w...

My choice was the regular Rockstar energy drink at my worst I was up to the large 750ml cans per day, then suddenly I developed back spasms for the first time in my life I thought it was a kidney stone. I could not straighten up I was curved to my right as if I was made of stone, the only thing that helped were strong muscle relaxers.

I stopped for awhile and drank just the normal ("double" is normal) Rockstar. I felt tingly all over mostly extremities. Now I have a fatty liver I am sure caused by energy drinks, I haven't had one in at least three years.

Coffee and tea are no comparison to energy drinks even a four or six shot espresso is mild in comparison. Although I believe espresso has less caffeine than regular coffee even for equal volumes.

What's odd is I never drank any caffeine until I was about 34 since even a sip affected me making my heart race from just a sip.

I've now left the stupid energy drink drinkers club!

//Although I believe espresso has less caffeine than regular coffee even for equal volumes. //

This is a common confusion. Espresso has more caffeine by volume.

Looking at ~8oz/236ml cup of 'regular' coffee versus ~1oz/29ml shot of espresso.

Check your math:

That's 236ml of caffeine for 8oz of coffee and 232ml of caffeine for espresso. That's less caffeine in espresso than coffee by volume.

According to Google (which cites USDA) for "espresso caffeine" and "coffee caffeine", there is 64 mg of caffeine in 1 fl oz of espresso and 94 mg of caffeine in 8 fl oz of coffee.

So per unit volume, the espresso has several times the caffeine (and you would already expect a double espresso to have more total caffeine than a modest sized drip coffee).

My math's fine. I think you misunderstood my post. I was just considering metric and imperial sizes thus included both sets of units.

The first reply to your post shows the math.

Even the 'increased' 240mg in the energy drink is just equivalent to 'regular' coffee due to it being 16oz/473mL can.

As I said though. Much easier to gulp down half a litre of sugary soda than half a litre of oily thick espresso.

I did misunderstand it, my apologies.

I suspect there are something else in energy drinks that could have dramatic effects on one's brain.

I usually drink one or two cups of coffee per day. I could drink more. After 7~8 cups of espresso, my hands start uncontrollably shaking, and I feel a little agitated. Those are all the symptoms I feel. Energy drinks is a completely different story. After two cans, I would have a big headache. I experimented a few times [call me crazy :)]. Every time, the headache came. So it was not a fluke, and most probably it was not caused by other factors.

> My choice was the regular Rockstar energy drink[...] fatty liver

Should've gone with the Rockstar Recovery. It's got milk thistle :)

Not to mention no sugar, which I suspect is the worst thing most people can get out of just grabbing a standard energy drink.

Just jacking up caffeine intake isn't the way to go. Add in 200mg of L-Tyrosine for every 100mg of caffeine. Look into compounds in the 'racetam' family which have proven to be effective at improving attention and memory. Be sure to take some choline (Alpha GCP seems good) along with any racetam, especially if you get headaches from the racetams, they can cause your brain to eat up choline. Nootropics is an interesting field, and if you're willing to turn yourself into a lab rat (you are anyway, so I guess its just a choice to be conscious of it), there are certainly better ways to improve functioning. Also, 5 Hour Energy drinks seem to be pretty good. A little bit of caffeine and a big dose of B vitamins.

Try taking L-Theanine with the caffeine if you're going to take that much because it will help with dependence and adrenal fatigue. And frankly, I would take a much smaller dose, and generally never take more than 300-400 mg per day. I think you need something that works in a different way than coffee, as the parent to my comment says, look into nootropics. Reddit.com/r/nootropics/faq is a good place to start.

L-Theanine also seems to improve the effect of caffeine in me; the caffeine makes me alert, but the theanine with it feels like my focus can't be broken unless I want it to.

Sounds really scary.

You should write up a PSA blog post about it.

Definitely plan on doing this. I think it's incredibly important for people to realize that you can't make health your last priority - not if you want to build a sustainable business. I had warning signs leading up until that moment that I foolishly ignored. I can't be the only one that has experienced this and if a blog post can make at least one person reconsider their behavior and save them or their family from trauma, it would be worth it.

Uh, days of sleep deprivation + lots of caffeine is recipe for disaster. I have read about people getting heart attacks from that kind of combination if you take it to extremes.

A similar thing actually happened to me - I wound up triggering a hemiplegic migraine, something I'd never experienced before. Unable to talk, focus my left eye, or feel anything on the left side of my body. Probably days of marathon coding along with dozens and dozens of Red Bulls.

To this day, I still get pretty nervous anytime I lean on an arm and it falls asleep or I get any tingling.

Glad you're okay, friend.

For what it's worth, I saw the same thing happen to a coworker with essentially the same circumstances. The doctors basically called it exhaustion.

I did nearly the same several years ago. Went a few days with little to no sleep, drank a bunch of huge energy drinks, and ended up in the hospital with tachycardia. No lasting damage, but I've definitely been more careful ever since.

When you collapsed, we're you also sleeping?

No, I was standing up.

Edit:

I'm not sure. Doctors didn't comment much on it, so unfortunately, I don't have a conclusive answer. But it does seem plausible that my body decided to override my willpower and decided to "shutdown".

I think OP was asking if you perhaps collapsed because you fell asleep on your feet. Or not.

I think you're right, that makes much more sense. Haha. Revised answer.

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