The hangover

The brother was over for a visit to my current home city of Cork. At a certain craft-beer establishment I partook of a few imperial stouts. Although not overly drunk when I returned home, on waking the next day I found it unusually difficult to keep anything in my stomach. Thankfully it was a Sunday, so there was no need to drag my sorry carcass into the workplace. The most complex thing I could handle was gawking at a movie with the brother. ("Reincarnated", the moving tale of Snoop Dogg's transition to Snoop Lion-truly the "Citizen Kane" of hip-hip to raggae crossover movies). Had I been that bad on a Monday morning I've little doubt my performance would have suffered.

The full economic cost of hangover is difficult to estimate-although sickies will lead to obvious losses, when asked to think of an example of presenteeism (turning up for work when you're not capable of working to your usual capacity) many of us will think of a hangover incident.

But what's the hard evidence for hangover effects? An interesting review by Richard Stephens and colleagues has discussed the impact of hangover on cognition. A majority of studies in this area have NOT shown an effect of hangover on cognitive performance, although Stephens contends this may sometimes be due to the use of insensitive measures. One study that did show an effect administered alcohol or placebo in the evening, and the next morning found worse delayed recall for a word list during hangover, despite an absence of an effect on a vigilance task, suggesting the memory effect was not simply due to fatigue. The other study found that psychomotor speed was slowed in addition to memory performance, suggesting sluggishness might have been at least part of the problem. This latter study used the more naturalistic approach of studying people after a normal night's drinking.

Stephens et al. suggest that the spectre of demand characteristics may hang over (heh heh) this research area. As mentioned above, one may study hangover in a controlled manner by giving a fixed amount of alcohol in a hangover condition. However, one may instead get some participants to come into the lab when they are hungover (after a night's drinking in a pub) and some to come in when they are not hungover. This second approach appears to more successful in demonstrating cognitive effects of hangovers. However, if invited to take part in such a study, one is essentially taking part in an "open-label" investigation. One may perform worse on cognitive tests during hangover, simply because this is what the experimental situation suggests to you.

However, Stephens et al. suggest an ingenious way around this. One can schedule some students to take part in your study on a morning after a popular drinking evening, and other students on a day when they are less likely to be drunk on the job. With enough numbers, you are likely to have a substantial proportion of the study participants attending while hungover (although perhaps the more severe cases will stay at home).

Even where performance is relatively preserved, the nauseous and draining subjective impact of heavy hangover does beg the question of whether we owe our future selves a lighter night's drinking. In many cases, I dare say a good behavioural medicine would be learning how to be a little less socially inhibited without having to resort to a few too many bevvies.

Stephens, R.; Ling, J.; Heffernan, T.M.; Heather, N. & Jones, K. (2008). A review on the cognitive effects of alcohol hangover. Alcohol & Alcoholism, 43(2), 163-170.