As Resident Doctors, we work 26h shifts with no sleep.
Coffee wasn’t enough to keep me sharp, so I dove into the literature for other solutions.
Here are my evidence-based protocols for using CREATINE to maximize cognitive performance during sleep deprivation
🧵1/12
Coffee wasn’t enough to keep me sharp, so I dove into the literature for other solutions.
Here are my evidence-based protocols for using CREATINE to maximize cognitive performance during sleep deprivation
🧵1/12
I had previously only heard of and used creatine for the purposes of exercise, such as to improve muscle mass and performance. However, I found several studies using creatine in the setting of sleep deprivation to improve cognitive performance. I also found a nice recent review on this in Sports Medicine /2
link.springer.com
link.springer.com
In the above review, they describe how creatine supplementation can increase brain creatine stores and improve:
1) Enhanced cognitive performance and memory, especially during sleep deprivation
2) Concussion recovery
3) Mood disorders /3
1) Enhanced cognitive performance and memory, especially during sleep deprivation
2) Concussion recovery
3) Mood disorders /3
So to develop a clear and evidence-based protocol, I dove into the methodology of the studies showing improvements in performance in a sleep deprived state. Lets go through some main studies below /4
Study #1
In this study, they had 10 elite rugby players do a passing skill test with either 1) Placebo 2) 50 or 100mg/Kg of creatine 3) 1 or 5 mg/kg caffeine. The players had improved performance to a similar degree with creatine and caffeine. Creatine had better performance than caffeine at higher doses but not to a statistically significant degree /5
pubmed.ncbi.nlm.nih.gov
In this study, they had 10 elite rugby players do a passing skill test with either 1) Placebo 2) 50 or 100mg/Kg of creatine 3) 1 or 5 mg/kg caffeine. The players had improved performance to a similar degree with creatine and caffeine. Creatine had better performance than caffeine at higher doses but not to a statistically significant degree /5
pubmed.ncbi.nlm.nih.gov
Study #1 Protocol: Creatine Kickstart
1) 50-100 mg/Kg of creatine
2)Take 1.5 hours before a period of sleep deprivation
3) When doing a 26h shift, I will usually take early in the night around when I usually go to sleep /6
1) 50-100 mg/Kg of creatine
2)Take 1.5 hours before a period of sleep deprivation
3) When doing a 26h shift, I will usually take early in the night around when I usually go to sleep /6
Study #2:
In another study, young adults who received creatine (20 g split into 4×5 g doses) had improvements in random movement generation, verbal and spatial recall, choice reaction time, static balance, and mood after 24 h of sleep deprivation compared with placebo
Subjects took 5 g of creatine monohydrate or a placebo four times a day for 7 days, immediately prior to the experiment /7
link.springer.com
In another study, young adults who received creatine (20 g split into 4×5 g doses) had improvements in random movement generation, verbal and spatial recall, choice reaction time, static balance, and mood after 24 h of sleep deprivation compared with placebo
Subjects took 5 g of creatine monohydrate or a placebo four times a day for 7 days, immediately prior to the experiment /7
link.springer.com
Study #2 Protocol: Consistent Creatine
1) 20g a day for a week before sleep deprivation
2) This is a quite high dose to take regularly, so after loading with around this dose for a week I go down to about 5g/day myself
3) This study suggests building up reserves of creatine creates a buffer on the negative effects related to sleep deprivation /8
1) 20g a day for a week before sleep deprivation
2) This is a quite high dose to take regularly, so after loading with around this dose for a week I go down to about 5g/day myself
3) This study suggests building up reserves of creatine creates a buffer on the negative effects related to sleep deprivation /8
Study #3:
This recent paper showed that a single dose of 0.35g/Kg improved cognitive performance and processing speed during a 21-hour period of sleep deprivation through short-term memory tasks (WMT, SPAN) and reaction speed.
They showed an improvement in performance for up to 9 hours after administration, with MAXIMUM effect 4h after administration /9
nature.com
This recent paper showed that a single dose of 0.35g/Kg improved cognitive performance and processing speed during a 21-hour period of sleep deprivation through short-term memory tasks (WMT, SPAN) and reaction speed.
They showed an improvement in performance for up to 9 hours after administration, with MAXIMUM effect 4h after administration /9
nature.com
Study #3 Protocol: Time It Right
1) 0.35g/Kg creatine the night of sleep deprivation
2) Take 4 hours before needing to perform at maximum level and effects lasted for up to 9 hours
3) I take at the beginning of the night of sleep deprivation /10
1) 0.35g/Kg creatine the night of sleep deprivation
2) Take 4 hours before needing to perform at maximum level and effects lasted for up to 9 hours
3) I take at the beginning of the night of sleep deprivation /10
Creatine supplementation is generally well tolerated but some people experience side effects such as stomach upset so it should be trialled slowly and its always a good idea to check with a doctor before starting a new supplement as it should be avoided in certain medical conditions such as kidney disease. Also, more long term safety data is required, but from the limited studies I have seen it is generally thought of as safe /11
Overall, these are exciting results that show how creatine can significantly boost cognitive performance during sleep deprivation, and I have noticed some very beneficial effects myself. These are only a few studies however, and more research is required. As well, there is no replacement for a good sleep as there are many detrimental physical and cognitive effects from sleep deprivation, well outlined in @sleepdiplomat book “Why We Sleep”. However, for those of us who do not have the option of always having a good sleep, creatine supplementation seems promising /12
If you are interested in some more on this topic, I also wrote a thread on how to leverage exercise against the negative side effects of sleep deprivation:
x.com
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