A systematic review of the next‐day effects of heavy alcohol consumption on cognitive performance

Gunn, Craig; Mackus, Marlou; Griffin, Chris; Munafò, Marcus R.; Adams, Sally · 2018 · OpenAlex-citations

DOI: 10.1111/add.14404

archive: archived pipeline: cataloged verified

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Summary

This systematic review and meta-analysis addresses the inconsistent findings regarding the cognitive effects of alcohol hangover, a phenomenon often poorly defined in prior literature. The authors aimed to evaluate and estimate mean effect sizes of next-day cognitive impairments following heavy alcohol consumption by applying a rigorous consensus definition of hangover: mental and physical symptoms experienced the day after a single episode of heavy drinking, occurring when blood alcohol concentration (BAC) approaches zero. This approach seeks to distinguish hangover effects from acute intoxication, which can persist at BAC levels above 0.02%. The researchers conducted a literature search across Embase, PubMed, and PsycNET between December 2016 and May 2018. From 805 identified articles, 19 studies involving 1,163 participants were included in the systematic review, and 11 studies provided sufficient data for meta-analysis. Inclusion criteria required studies to involve healthy adults, include a no-hangover control condition, validate hangover presence via symptom questionnaires, and report BAC < 0.02% at testing. Data were extracted for study design, hangover severity, and cognitive performance, with tasks categorized into attention, memory, and psychomotor domains. Meta-analyses were performed using RevMan, calculating Hedges’ g effect sizes weighted by inverse variance. The results indicated that sustained attention and driving abilities were consistently impaired during hangover. The meta-analysis revealed significant cognitive impairments in short-term memory (Hedges’ g = 0.64, 95% CI = 0.15–1.13), long-term memory (Hedges’ g = 0.59, 95% CI = 0.01–1.17), sustained attention (g = 0.47, 95% CI = 0.07–0.87), and psychomotor speed (Hedges’ g = 0.66, 95% CI = 0.31–1.00). Findings for divided attention, working memory, and psychomotor accuracy were mixed. The review noted that laboratory studies typically used lower alcohol doses than naturalistic studies, and risk of bias assessments highlighted issues such as insufficient randomization and lack of pre-registration in included studies. The study concludes that alcohol hangovers significantly impair specific cognitive functions, particularly memory, sustained attention, and psychomotor speed, which may affect the performance of everyday tasks such as driving. By enforcing strict criteria for BAC and hangover validation, this review provides more robust evidence than previous studies, suggesting that next-day cognitive deficits are a real consequence of heavy drinking. These findings have implications for public health and safety, highlighting the risks associated with operating vehicles or machinery while experiencing hangover symptoms.

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• alcohol