Stress response to virtual reality based active shooter training: Impact of caffeine consumption.

Participation in a virtual reality based active shooter training drill (VR-ASD) has been shown to increase biomarkers of stress; however, the impact of caffeine consumption on this response has not been studied. Caffeine ingestion has been shown to have favorable effects on physical and cognitive performance among athletic and tactical occupations alike. This study examined the impact of caffeine ingestion on subjective and physiological markers of stress in response to a mental stress task (MST) which involved participation in a VR-ASD and cognitive challenge consisting of mental arithmetic and a Stroop challenge. Fifty-three subjects were randomly assigned either caffeine (n = 26) or placebo (n = 27) prior to being exposed to the MST. Saliva samples, heart rate (HR), and state-anxiety inventory (SAI) scales, were collected before and after exposure to the MST. Saliva was analyzed for α-amylase (sAA), secretory IgA (SIgA), and cortisol (sCORT) concentrations. The MST resulted in significant increases in sAA, SIgA, HR, and SAI. Immediately post MST, sAA concentrations were significantly higher following the caffeine treatment compared to placebo. These data demonstrate that caffeine consumption results in significantly greater sAA concentrations post MST. This study was pre-registered as a clinical trial ("Impact of supplements on stress markers": NCT05592561).