Daily Life Stress and the Cortisol Awakening Response: Testing the Anticipation Hypothesis

Abstract

The cortisol awakening response (CAR) is a distinct facet of the circadian cortisol rhythm associated with various health conditions and risk factors. It has repeatedly been suggested that the CAR could be a result of the anticipated demands of the upcoming day (stress anticipation) and could support coping with daily life stress. In a sample of 23 healthy participants CARs were assessed on two consecutive days by measures of salivary cortisol upon awakening (S1) and 30 and 45 minutes later, which were aggregated to the area under the curve increase (AUCI). Stress anticipation was assessed immediately after awakening. On the same days, daily life stress and distress were assessed six times per day based on a quasi-randomized design using handheld computers. Associations were tested by day using regression analysis and standard multilevel/mixed effects models for longitudinal data. The CAR AUCI moderated the effect of daily life stress on distress; higher CAR increases were associated with attenuated distress responses to daily life stress on both days (day 1: p = .039; day 2: p = .004) adjusted for age, gender, sleep quality, time of awakening and oral contraceptive use. Lagged-effects and redundancy models showed that this effect was not due to prior-day CAR increases but specific for same day CARs. On day 2, associations between daily life stress and distress were stronger when individuals showed a higher S1 cortisol level, but this effect was similar for S1 on day 1, and the day 2 effect of S1 became non-significant when S1 on day 1 was controlled. No associations were found between stress anticipation and CARs. Findings indicate that the CAR increase is associated with successful coping with same-day daily life stress.

Much ado about much: Stress, dynamic biomarkers and HPA axis dysregulation along the trajectory to psychosis

“…2) In contrast to the cortisol response to acute exogenous stressors described above, the rapid increase in cortisol normally seen within the 30 minute period after awakening may reflect endogenous diurnal activation of the HPA axis, potentially signifying a readiness to respond to (or cope with) the stress of the upcoming day. Higher increases in the Cortisol Awakening Response (CAR) are associated with attenuated levels of distress in response to daily life stressors in healthy controls (Powell and Schlotz, 2012). In FEP the CAR is blunted (Mondelli et al, 2010a), potentially interacting with cannabis misuse (Monteleone et al, 2014).…”

Day-to-Day Dynamics of Associations Between Sleep, Napping, Fatigue, and the Cortisol Diurnal Rhythm in Women Diagnosed as Having Breast Cancer

“…Although largely untested, the stress anticipation hypothesis is supported by research demonstrating higher CAR during week-days versus week-ends (51–53) and during athletic competition days versus non-competition days (54). Further support for the stress anticipation hypothesis is provided by a study of healthy adults that demonstrated an association between a higher CAR and an attenuated stress response to stressors encountered later that same day (55). Our results show that women newly diagnosed with breast cancer exhibit a higher CAR when they report feeling less rested in the morning.…”

Daily family stress and HPA axis functioning during adolescence: The moderating role of sleep

“…Indeed, prior work has shown that a greater CAR is associated with attenuated distress responses to stress (Powell and Schlotz, 2012). Under burnout conditions, however, the HPA axis exhibits hypocortisolism, characterized by a blunted CAR (Chida and Steptoe, 2009; Oosterholt et al, 2015).…”