The lack of sleep/caffeine dependence cycle of pain

Consider the simple medical student. He or she must strive to keep a balance between the positive and negative factors that are plentiful in his or her day to day life. These factors in the most loose sense can be defined as such:
Positive factors: Any such thing which ensures the health of the medical student. (Sleep, free food, free books - free anything, really, time at the gym etc).
Negative factors: Any such thing which may be detrimental to the health of the medical student. (Lack of sleep, stress, ultra-competitive cut throat classmates etc).
It started out innocently enough - happenings that in themselves did not pose any serious obstacle to the health of this medical student. A desire to attend Neurosurgery grand rounds the next morning; a shocking amount of material covered in lecture that day and the next; a dramatic increase in the amount of work to be accomplished in lab that night, a presentation in the next morning's class....in fact, a total of 6 negative factors combined to be the straw that broke the life-balance camel's back. A series of unfortunate events, if you will.
I worked late into the night, hoping to get both my studying for the day's lectures AND my reading for tomorrow done while working in lab. A free dinner would have been a bonus but I didn't plan on spending an hour at a meeting, no matter how good their food.
By 12am I was done studying, had completed my work, but hadn't read for class the next day nor practiced my presentation (which, by the way, is only for an informal PBL small group presentation, but if I don't practice I tend to suck at it. A lot).
Of course I had to get up early the next morning (5am instead of 6:40am) in order to avoid the slippery slope that is Falling Behind In Medical School. (A catastrophe of cataclysmic proportions) I did my reading for that day's lectures and practiced my presentation with time to go to the gym. In order to stay awake during lecture, however, the smoky brew of coffee was necessary. With even more lectures gushing forth material surely to be covered in the next test, lab work, studying and reading to be done, the allure of the brew became too strong to resist.
Now, one week later, I am slowly weaning myself off the brew and enduring many a gaping yawn. I'll see how next week goes...