Benefits
Alertness and reduced mental fatigue
Caffeine blocks adenosine receptors, and low to moderate doses (about 40 to 300 mg) improve alertness, vigilance, attention and reaction time. In a double-blind crossover trial of 48 adults, 75 or 150 mg reduced self-rated mental fatigue and raised alertness in both regular and non-regular users. In soldiers kept awake on three nights, repeated 200 mg doses kept reaction speed and vigilance up.
Endurance and exercise performance
A meta-analysis of 40 double-blind studies found caffeine improved exercise test results by 12.3% versus placebo, most for endurance and time-to-exhaustion tests. In eight trained runners, 3 and 6 mg per kg each extended running time by about 22%, while 9 mg per kg gave no significant gain. Gains in strength and sprinting are small to moderate and not seen in every study.
Attention and reaction time
Reviews find caffeine speeds reaction time and improves attention, but it does not usually help learning or long-term memory and can hinder tasks that lean heavily on working memory. In a double-blind trial of 102 light users, it improved vigilance and reaction time but impaired a memory task. Its thinking benefits come largely from effects on arousal and are larger when people are tired.
Exercise feels easier
A meta-analysis of 21 studies found caffeine lowered ratings of perceived exertion during exercise by 5.6% compared with placebo, and this lower sense of effort explained about 29% of the improvement in performance.
Short-term mood lift
At low doses caffeine improves hedonic tone, a measure of pleasant mood, and reduces anxiety, while high doses raise tension, anxiety and jitteriness. In placebo-controlled trials, single doses raised positive mood and alertness ratings, and regular users tended to get more mood benefit than non-users. These are short-term effects in healthy people; whether regular use improves mood over time is uncertain.
Mechanism of action
Adenosine receptor blockade
Caffeine blocks adenosine receptors, which is the main way it raises alertness, attention and reaction time and affects physical performance.
Lower perceived effort
During exercise, caffeine makes the same workload feel easier, which accounts for part of its performance benefit.
Arousal rather than pure brain boosting
Caffeine acts mainly as a mild stimulant. Its effects on arousal, mood and concentration drive most of its cognitive benefits, which is why gains are larger in tired people and smaller for memory.
Why people respond differently
In 101 male athletes, caffeine sped a 10 km cycling time trial only in carriers of the AA version of the CYP1A2 gene, had no effect in AC carriers and slowed CC carriers at 4 mg per kg. Genes linked to caffeine metabolism and response, and habitual intake, also help explain why effects on sleep and anxiety vary.
Clinical trials
Meta-analysis of 40 double-blind studies with 76 effect sizes (Doherty et al. 2004, Int J Sport Nutr Exerc Metab)
Participants in endurance, graded and short-term exercise tests
Caffeine improved exercise test outcomes by 12.3% (95% CI 9.1 to 15.4) versus placebo, an effect size of 0.41. Endurance tests improved more than graded or short-term tests, and time-to-exhaustion protocols showed the largest effect.
Meta-analysis of 21 studies with 109 effect sizes (Doherty et al. 2005, Scand J Med Sci Sports)
Participants in constant-load and exhausting exercise tests
Caffeine lowered ratings of perceived exertion during exercise by 5.6% (effect size -0.47) but not at the end of exhausting exercise, and improved performance by 11.2%. Lower exertion explained about 29% of the performance gain.
Placebo-controlled trial of capsules with placebo or 3, 6 or 9 mg per kg caffeine taken 1 hour before running at 85% of maximal oxygen uptake to exhaustion, after 48 hours without caffeine (Graham et al. 1995, J Appl Physiol (1985))
8 well-trained endurance athletes
Running time to exhaustion rose by about 22% with both 3 and 6 mg per kg (placebo time 49.4 minutes), while 9 mg per kg had no significant effect. Only the higher doses raised epinephrine, so the authors concluded the endurance gain was not explained by catecholamines.
Split-plot randomized, double-blind, placebo-controlled trial of 0, 2 or 4 mg per kg caffeine before a 10 km cycling time trial, with genotyping of the CYP1A2 gene (rs762551) (Guest et al. 2018, Med Sci Sports Exerc)
101 competitive male athletes, mean age 25
Overall, 4 mg per kg cut cycling time by 3% versus placebo (17.6 vs 18.1 minutes). The effect depended on genotype: AA carriers were 4.8% faster at 2 mg per kg and 6.8% faster at 4 mg per kg, AC carriers saw no effect, and CC carriers were 13.7% slower at 4 mg per kg.
Placebo-controlled double-blind balanced crossover trial of 75 mg, 150 mg caffeine or placebo after overnight abstinence (Haskell et al. 2005, Psychopharmacology (Berl))
24 habitual caffeine consumers and 24 non-consumers
Caffeine improved simple reaction time, vigilance reaction time, working memory reaction time and sentence verification accuracy, reduced self-rated mental fatigue and raised alertness in both groups. Consumers tended to get more mood benefit and non-consumers more benefit on the tasks.
Randomized placebo-controlled trial of four 200 mg doses (800 mg a day) or placebo given in the late evening and early morning on three successive nights, each followed by a 4 hour afternoon sleep (Kamimori et al. 2015, Psychopharmacology (Berl))
20 Special Forces soldiers, 10 per group
Caffeine maintained psychomotor vigilance speed, improved event detection in field vigilance testing, increased correct responses on a vigilance monitor and sped logical reasoning across all three nights. Live-fire marksmanship was not changed.
Randomized double-blind within-subject trial of 0, 50, 150 and 450 mg caffeine capsules in four sessions, with tasks 40 minutes after dosing (Childs et al. 2006, Psychopharmacology (Berl))
102 light, nondependent caffeine users
Caffeine raised feelings of arousal, positive mood and high, increased hits and shortened reaction times on a vigilance task, but impaired scores on a memory task and raised blood pressure.
Randomized double-blind, placebo-controlled crossover trial of 400 mg caffeine at bedtime or 3 or 6 hours before, with sleep measured at home by a portable monitor and a diary; funded by a grant from the monitor's maker (Zeo Inc), and one author was listed with that company (Drake et al. 2013, J Clin Sleep Med)
12 healthy normal sleepers aged 19 to 48
All three timings disturbed sleep compared with placebo. Even at 6 hours before bed, the monitor showed more than 1 hour less sleep, while diary-reported sleep fell by 41 minutes, which was not significant (p = 0.08).
Multicenter double-blind randomized trial of 200 mg or 400 mg caffeine or placebo 90 minutes before a repeat regadenoson stress scan (Tejani et al. 2014, Int J Cardiovasc Imaging)
207 adults with a high likelihood of coronary artery disease
Both caffeine doses reduced the number of heart segments where the scan detected reduced blood flow, while placebo did not (P < 0.001), meaning caffeine can hide findings on this test.