Differences in Next-Day Adverse Effects and Impact on Mood of an Evening of Heavy Alcohol Consumption between Hangover-Sensitive Drinkers and Hangover-Resistant Drinkers.

The combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero, are collectively referred to as the alcohol hangover. Previous research revealed that 10 to 20% of drinkers claim not to experience next-day hangovers. Past studies were usually limited to single timepoint assessments. The aim of the current semi-naturalistic study was to compare the next-day effects of an evening of alcohol consumption of self-reported hangover-resistant drinkers (n = 14) with those of a group of self-reported hangover-sensitive drinkers (n = 15) at hourly timepoint throughout the day (09:30 until 15:30). Assessments of 23 hangover symptoms, mood (Profiles of Mood States-Short Form), and daytime sleepiness (Karolinska Sleepiness Scale) were made hourly after both an alcohol day and an alcohol-free control day. Additional morning assessments were made for mood (State-Trait Anxiety Inventory-Y, Beck's Depression Inventory-II), risk-taking behavior (RT-18), past night sleep (Groningen Sleep Quality Scale), alcohol consumption, and activities during the test days. No significant differences were found regarding the amount of alcohol consumed and the total sleep time of the two groups. The hangover-sensitive group reported having a hangover as well as the presence of a variety of hangover-related symptoms, which were most severe in the morning and then gradually decreased during the day. The most frequently reported and most severe symptoms were sleepiness and fatigue, concentration problems, and headache. In contrast, the hangover-resistant group reported the absence of a hangover and the presence and severity of next-day symptoms did not significantly differ from the control day, except for increased fatigue and reduced vigor. The next-day effects on sleepiness-related complaints and vigor were significantly more pronounced among hangover-sensitive drinkers compared to hangover-resistant drinkers. In conclusion, contrary to hangover-resistant drinkers, hangover-sensitive drinkers report a variety of hangover symptoms that gradually ease during the day, but are still present in the afternoon.

Associations between Mental Resilience, Mood, Coping, Personality, and Hangover Severity.

Extensive research exists on relationships between psychological constructs and alcohol consumption. However, research on relationships with hangover severity remains limited. This study aimed to assess the associations between mental resilience, mood (i.e., depression, anxiety, and stress), coping, personality, and hangover severity. A total of N = 690 participants completed an online survey by answering questions regarding their demographics, alcohol use, hangover prevalence and severity, and several psychological assessments (Brief Resilience Scale, DASS-21, Brief Cope, and Brief Version of the Big Five Personality Inventory). Significant associations were found between hangover severity and mental resilience, mood, and avoidant coping. Higher levels of mental resilience were associated with less severe hangovers, whereas poorer mood was associated with more severe hangovers. No significant associations were found with personality traits. These findings demonstrate that several associations between psychological constructs and hangover severity exist and suggest a role of psychological factors in the pathology of the alcohol hangover. As our findings contrast with the results of previous studies that did not report an association between mental resilience and the presence and severity of hangovers, further research is warranted.

Correction: Terpstra et al. Prevalence of Hangover Resistance According to Two Methods for Calculating Estimated Blood Alcohol Concentration (eBAC). J. Clin. Med. 2020, 9, 2823.

The authors wish to make the following corrections to the original article [...].

Prevalence of Hangover Resistance According to Two Methods for Calculating Estimated Blood Alcohol Concentration (eBAC).

Hangover resistance may be linked to an increased risk of continuing harmful drinking behaviours as well as involvement in potentially dangerous daily activities such as driving while hungover, mainly due to the absence of negative consequences (i.e., hangover symptoms) the day after alcohol consumption. The aim of this study was to examine the occurrence of claimed alcohol hangover resistance relative to estimated blood alcohol concentration (eBAC). A total of 1198 participants completed an online survey by answering questions regarding their demographics, alcohol consumption and occurrence of hangover. Two methods were used to calculate eBAC, one based on the modified Widmark Equation (N = 955) and the other from an equation averaging the total body water (TBW) estimates of Forrest, Watson, Seidl, Widmark and Ulrich (males only) (N = 942). The percentage of participants who claimed to be hangover resistant decreased rapidly with increasing eBAC and only a small number of hangover resistant drinkers remained at higher eBACs. Comparisons of the eBACs calculated by the two methods revealed significantly higher BACs when using the modified Widmark equation. These findings suggest that additional research for eBAC calculations is needed to improve accuracy and comprehensiveness of these equations for future alcohol hangover research.

Sensitivity to Experiencing Alcohol Hangovers: Reconsideration of the 0.11% Blood Alcohol Concentration (BAC) Threshold for Having a Hangover.

The 2010 Alcohol Hangover Research Group consensus paper defined a cutoff blood alcohol concentration (BAC) of 0.11% as a toxicological threshold indicating that sufficient alcohol had been consumed to develop a hangover. The cutoff was based on previous research and applied mostly in studies comprising student samples. Previously, we showed that sensitivity to hangovers depends on (estimated) BAC during acute intoxication, with a greater percentage of drinkers reporting hangovers at higher BAC levels. However, a substantial number of participants also reported hangovers at comparatively lower BAC levels. This calls the suitability of the 0.11% threshold into question. Recent research has shown that subjective intoxication, i.e., the level of severity of reported drunkenness, and not BAC, is the most important determinant of hangover severity. Non-student samples often have a much lower alcohol intake compared to student samples, and overall BACs often remain below 0.11%. Despite these lower BACs, many non-student participants report having a hangover, especially when their subjective intoxication levels are high. This may be the case when alcohol consumption on the drinking occasion that results in a hangover significantly exceeds their "normal" drinking level, irrespective of whether they meet the 0.11% threshold in any of these conditions. Whereas consumers may have relative tolerance to the adverse effects at their "regular" drinking level, considerably higher alcohol intake-irrespective of the absolute amount-may consequentially result in a next-day hangover. Taken together, these findings suggest that the 0.11% threshold value as a criterion for having a hangover should be abandoned.

Effects of Alcohol Hangover on Cognitive Performance: Findings from a Field/Internet Mixed Methodology Study.

Results from studies into the cognitive effects of alcohol hangover have been mixed. They also present methodological challenges, often relying on self-reports of alcohol consumption leading to hangover. The current study measured Breath Alcohol Concentration (BAC, which was obtained via breathalyzer) and self-reported drinking behavior during a night out. These were then related to hangover severity and cognitive function, measured over the internet in the same subjects, the following morning. Volunteers were breathalyzed and interviewed as they left the central entertainment district of an Australian state capital. They were provided with a unique identifier and, the following morning, logged on to a website. They completed a number of measures including an online version of the Alcohol Hangover Severity Scale (AHSS), questions regarding number and type of drinks consumed the previous night, and the eTMT-B-a validated, online analogue of the Trail Making Test B (TMT-B) of executive function and working memory. Hangover severity was significantly correlated with one measure only, namely the previous night's Breath Alcohol Concentration (r = 0.228, p = 0.019). Completion time on the eTMT-B was significantly correlated with hangover severity (r = 0.245, p = 0.012), previous night's BAC (r = 0.197, p = 0.041), and time spent dinking (r = 0.376, p < 0.001). These findings confirm that alcohol hangover negatively affects cognitive functioning and that poorer working memory and executive performance correlate with hangover severity. The results also support the utility and certain advantages of using online measures in hangover research.