Journal ArticleDOI
The awakening cortisol response: Methodological issues and significance
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TLDR
A review explores reasons for discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence that suggest the awakening cortisol response is under a distinct regulatory influence different from the rest of the diurnal cortisol secretory cycle.Abstract:
The awakening cortisol response (ACR) is a discrete and distinctive part of the cortisol circadian cycle. In healthy adults salivary free cortisol concentrations increase by between 50 and 160% in the first 30 min immediately post-awakening (approximate average increase of 9 nmol/l, range 4-15 nmol/l, estimated to be equivalent to about three secretory episodes). However there are no agreed norms for the absolute concentrations of free cortisol in saliva either immediately post-awakening (range of 4.7-18.5 nmol/l) or 30 min post-awakening (range of 8.6-21.9 nmol/l). This review explores reasons for these discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence. Although the physiological role of the ACR has not been clearly defined evidence is discussed that suggests it is under a distinct regulatory influence, different from the rest of the diurnal cortisol secretory cycle. Despite the difficulties associated with its measurement a range of studies have demonstrated an association between the ACR and psychosocial variables, stress and health. However it remains unclear whether positive affect and good health are consistently associated with larger or smaller awakening responses. It is early days in the search for the role and significance of the ACR. Its putative role in the regulation of physiological function across the day (e.g. the immune system) and its sensitivity to psychosocial variables make it a prime candidate as an intermediary linking mind and health.read more
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References
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Free Cortisol Levels after Awakening: A Reliable Biological Marker for the Assessment of Adrenocortical Activity
Jens C. Pruessner,Oliver T. Wolf,Dirk H. Hellhammer,Angelika Buske-Kirschbaum,K. von Auer,Silke Jobst,F. Kaspers,Clemens Kirschbaum +7 more
TL;DR: Early morning cortisol levels can be a reliable biological marker for the individual's adrenocortical activity when measured repeatedly with strict reference to the time of awakening, in contrast to single assessments at fixed times.
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Diurnal Cortisol Rhythm as a Predictor of Breast Cancer Survival
TL;DR: Patients with metastatic breast cancer whose diurnal cortisol rhythms were flattened or abnormal had earlier mortality, and suppression of NK cell count and NK function may be a mediator or a marker of more rapid disease progression.
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Burnout, perceived stress, and cortisol responses to awakening.
TL;DR: Sixty-six teachers from local public schools (42 womenand 24 men, mean age 42 6 5 years) were asked to sample saliva for cortisol analysis on 3 consecutive days as discussed by the authors.