Impact of caffeine consumption on headache severity, sleep quality, and psychiatric symptoms in patients with idiopathic intracranial hypertension: a cross-sectional study

BACKGROUND: The relationship between caffeine consumption and idiopathic intracranial hypertension (IIH) remains an area of clinical interest, but with limited research. This work aimed to clarify the impact of caffeine consumption on headache severity, quality of life, psychiatric symptoms, and sleep quality in patients with IIH. METHODS: This cross-sectional study included 179 patients diagnosed as having IIH. At the baseline visit, the patients underwent a detailed clinical assessment. They were subsequently asked to complete a set of self-administered questionnaires after one month: the Caffeine Food Frequency questionnaire (C-FFQ), Headache Impact Test-6 (HIT-6), Depression Anxiety Stress Scale-12 (DASS-12), Insomnia Severity Index (ISI), and the Short-Form Health Survey (SF-12). Patients were categorized as heavy caffeine consumers (≥ 400 mg/day), light consumers (< 400 mg/day), or non-consumers. RESULTS: Heavy caffeine consumers showed significantly higher rates of severe papilledema, elevated CSF pressure, and greater daily dose of acetazolamide compared to light and non-consumers (P < 0.001). Headache burden was significantly greater among heavy consumers compared to light and non-consumers, with higher median monthly headache days (MHDs) [20 vs. 15 vs. 10], visual analogue scale (VAS) pain scores [9 vs. 7 vs. 7], and HIT-6 scores [66 vs. 63 vs. 57] (all P < 0.01). Moreover, heavy consumers reported significantly lower quality of life on SF-12 physical and mental domains, and higher DASS-12 and ISI scores compared to light and non-consumers (P < 0.001). CONCLUSION: In IIH patients, heavy caffeine consumption was associated with worse headache burden, impaired quality of life, and increased psychiatric and sleep disturbances.