Day-to-day variation in saliva cortisol—Relation with sleep, stress and self-rated health

Dahlgren, Anna; Kecklund, Göran; Theorell, T.; Åkerstedt, Torbjörn

doi:10.1016/j.biopsycho.2009.07.001

Cited by 125 publications

(115 citation statements)

References 44 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…We observed a negative correlation between the salivary cortisol at awakening and the relative increment of salivary cortisol at the peak after awakening in healthy subjects, obese, and in remission CD patients, indicating that high levels of awakening cortisol are associated with attenuated CAR in these three control groups. Our data in controls are in agreement with previous studies also performed in healthy individuals (7,33,34). In addition, we expanded this knowledge to obese and in remission CD patients, in which groups a similar negative correlation was observed between the salivary cortisol at awakening and its relative increment at the peak after awakening.…”

Section: Discussionsupporting

confidence: 91%

The cortisol awakening response is blunted in patients with active Cushing's disease

Roa

Elias

Castro

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Introduction: Cortisol awakening response (CAR) is a rapid increase of cortisol levels within 30-45 min after awakening. Objective: This study evaluates CAR compared with cortisol circadian rhythm in active and in remission Cushing's disease (CD). Materials and methods: We evaluated healthy controls (HC, nZ19), obese (OB, nZ10), in remission (nZ08), and active CD patients (nZ10). Salivary free cortisol (SF) was determined at 0800, 1100, 1700, 2000, and 2300 h on the first day. CAR was obtained the next morning immediately upon awakening and at 15, 30, 45, and 60-min post-wake up. Results: We observed differences in SF levels throughout the day in HC, OB, and in remission CD (ANOVA PZ0.0001) but not in active CD (PZ0.2). We demonstrated SF increment after awakening in HC, OB, and in remission CD (ANOVA PZ0.007), with no effect of time on SF in active CD. The relative increment of SF obtained at the peak after awakening (CARi%) in the active CD (67G57%) was lower than in HC (154G107%), OB (240G188%), and in remission CD (186G184%) patients (PZ0.009). There was a negative correlation between the SF at awakening and the CARi% in HC (rZK0.8), OB (rZK0.78), and in remission CD (rZK0.74) but not in active CD (rZK0.35; PZ0.31). Conclusion: This study originally described a blunted CAR in active CD in contrast to its presence in HC, OB, and in remission CD. This subtle dysfunction of the hypothalamus-pituitary-adrenal axis may represent a distinct and additional physiopathological phenomenon superimposing the dysregulated cortisol circadian rhythm in this disease.

show abstract

Section: Discussionsupporting

confidence: 91%

The cortisol awakening response is blunted in patients with active Cushing's disease

Roa

Elias

Castro

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…Importantly, the day-to-day analysis of this data suggests that rather than a pervading reduction in the CAR over time, the lower CAR was seen only after days when hassles were appraised as stressful (demands outweighed resources). In another day-to-day study, general stress was shown to predict higher levels of cortisol at bedtime while anxiety was shown to predict lower levels of cortisol the next morning (Dahlgren et al, 2009). …”

Section: Discussionmentioning

confidence: 96%

“…Please note that the personspecific variance was still modelled in these analyses. Furthermore, in previous research, time of waking has been controlled for in models of the CAR (Dahlgren et al, 2009;Stalder et al, 2009). In the current data set, no significant correlations were found between waking time and either the S1 or the CAR AUCi (r = -.24, p = .77; r = .04, p = .62 respectively); therefore, waking time was not included in these analyses (average waking time was 7:28am, ranging from 5:40am to 11:00am).…”

Section: Analytic Strategymentioning

confidence: 99%

“…A variety of daily experiential factors have been shown to be related to ambulatory cortisol levels, including daily stress events, affect/mood, and anticipation of obligations (Jacobs et al, 2007; for review see Kudielka, Gierens, Hellhammer, Wust, & Schlotz, 2012;Stalder, Evans, Hucklebridge, & Clow, 2010a;van Eck et al, 1996). In a 28-day study of daily experience and cortisol, low cortisol levels in the morning were related to anxiety, exhaustion, sleepiness at awakening and poor health the day before; while high levels of cortisol in the evening were related to stress and poor health (Dahlgren et al, 2009). Doane and Adam (2010) demonstrated the importance of day-to-day designs by showing that prior-day feelings of loneliness, worry or stress produced disruptions to the CAR the following morning, but not when the CAR variables were averaged across the study days.…”

Section: Introductionmentioning

confidence: 99%

“…However, recent research has observed that intraindividual day-to-day variations in the CAR may be associated with daily experiences and state-specific factors (Dahlgren, Kecklund, Theorell, & Akerstedt, 2009;Hellhammer et al, 2007; for review see Law, Hucklebridge, Thorn, Evans, & Clow, 2013;O'Connor et al, 2013;Stalder, Hucklebridge, Evans, & Clow, 2009;Thorn, Hucklebridge, Evans, & Clow, 2009). Research has also demonstrated the value of analysing this variability with multi-level modelling (Almeida, Piazza, & Stawski, 2009;van Eck, Berkhof, Nicolson, & Sulon, 1996).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exploring day-to-day dynamics of daily stressor appraisals, physical symptoms and the cortisol awakening response

Gartland

O’Connor

Lawton

et al. 2014

Psychoneuroendocrinology

View full text Add to dashboard Cite

Stress is associated with the secretion of cortisol throughout the day, but less is known about the dynamic effects of stress on the cortisol awakening response (CAR). More widely, knowledge of the causal factors and functions of the CAR are also not fully understood. This study explored: (1) the effects of daily stressors on the next day CAR and; (2) the effects of the CAR on same day physical and affective outcomes. Sixty-four participants completed a daily diary, reporting on the occurrence of daily stressors and stress appraisals, physical symptoms, and affect. Cortisol was measured at 0, 15, 30, and 45 minutes after awakening to provide measures of the CAR on 3 consecutive work days. Stress appraisal was found to negatively predict the CAR, such that where stressors were appraised as more stressful (where perceived demands exceeded resources), the CAR increased less the following morning. Furthermore, the CAR significantly predicted same-day physical symptoms such that a lower CAR was associated with more physical symptoms. This study provides evidence for a pathway through which daily stressors may influence physical wellbeing, and highlights the importance of appraisals for future stress-based cortisol research.

show abstract

Who is stressed? Comparing cortisol levels between individuals

Nepomnaschy

Lee

Zeng

et al. 2012

American J Hum Biol

View full text Add to dashboard Cite

The use of single raw cortisol values is inadequate to compare physiological stress levels across individuals. If the distributions of individuals' cortisol values are approximately normal, then the standardized ranking method is most appropriate; otherwise, the sample percentile method is advised. These methods may be applied to compare stress levels across individuals in other populations and species.

show abstract

Day-to-day variation in saliva cortisol—Relation with sleep, stress and self-rated health

Cited by 125 publications

References 44 publications

The cortisol awakening response is blunted in patients with active Cushing's disease

The cortisol awakening response is blunted in patients with active Cushing's disease

Exploring day-to-day dynamics of daily stressor appraisals, physical symptoms and the cortisol awakening response

Who is stressed? Comparing cortisol levels between individuals

Contact Info

Product

Resources

About