Review * A review of the literature on the cognitive effects of alcohol hangover

Abstract

Alcohol misuse is a prime social and health problem in the UK. This paper presents a critical review of literature on the performance effects in the morning after binge drinking - during the alcohol hangover. Several pathophysiological changes that both follow and outlast acute intoxication may give rise to alcohol hangover effects. We have identified 27 English language peer-reviewed studies that investigate aspects of psychological performance during alcohol hangover following controlled alcohol ingestion. However, the majority of studies had basic methodological shortcomings. Of eight laboratory studies rigorous enough to warrant serious attention, only two showed effects. We interpret these largely negative findings as evidence of an insensitivity that is intrinsic to laboratory-based studies of performance under the influence of alcohol. Several studies have investigated the cognitive consequences of hangover subsequent to naturalistic consumption, where participants have chosen what and where to drink. Although these studies have tended to show effects, participants were always informed at the outset that hangover effects were to be assessed, and participants knew which was the hangover condition. Under these circumstances expectancy effects have possibly contaminated the results significantly. Therefore, naturalistic alcohol consumption studies (and laboratory studies that did not employ a placebo) can be considered as being suggestive of hangover effects, but should not be interpreted as providing definitive evidence of such effects. In conclusion, although there is empirical evidence showing impaired performance as a result of the alcohol hangover, future studies should confirm these findings and overcome the shortcomings of previous research.

Binge Drinking

“…40 A "hangover" is a constellation of symptoms that usually occur within 6 to 24 hours after a heavy or prolonged drinking episode. 38, 41 The symptoms include headache, drowsiness, dizziness, inability to concentrate, dry mouth, gastrointestinal complaints including nausea and vomiting, sweating, hyperexcitability, muscle weakness or pain, tremors, tachycardia, hyperventilation, depression, irritability, and anxiety. 38, 41 Thought processes and learning are also impaired.…”

“…38, 41 The symptoms include headache, drowsiness, dizziness, inability to concentrate, dry mouth, gastrointestinal complaints including nausea and vomiting, sweating, hyperexcitability, muscle weakness or pain, tremors, tachycardia, hyperventilation, depression, irritability, and anxiety. 38, 41 Thought processes and learning are also impaired. 38 Adolescence is a period of ongoing brain maturation that is characterized by specific and ordered changes in brain structure that hone the functioning of neural circuits in the service of achieving optimal cognitive, emotional, and higher-order executive functioning.…”

The Effects of Sleep Deprivation, Caffeine, and Alcohol on Simulated Neurosurgical Performance

“…alcohol consumption the evening prior to neurosurgery on surgical performance. The "hangover effect" is thought to decrease memory, psychomotor vigilance, and fine motor dexterity [16,17]. This knowledge is what had led to the Federal Aviation Administration "bottle-to-throttle" rule where pilots cannot fly a civilian aircraft within 8 hours after the consumption of any alcoholic beverage [18].…”

Hangover

“…Having said that, in the last decade there has been some notable interest in the question as to how hangover impairs cognition, for example visual and spatial impairment of the body (e.g. Stephens et al 2008), reaction time (McKinney & Coyle 2004) and memory deficits (Ling et al 2010).…”