TY - JOUR
T1 - The cortisol awakening response - applications and implications for sleep medicine
AU - Elder, Greg
AU - Wetherell, Mark
AU - Barclay, Nicola
AU - Ellis, Jason
PY - 2014/6/1
Y1 - 2014/6/1
N2 - The stress hormone cortisol is the end product of the hypothalamic–pituitary–adrenal (HPA) axis, and the cortisol awakening response (CAR) refers to the rapid rise in cortisol levels observed immediately following awakening. During the CAR period, cortisol levels typically increase by 38%–75%, peaking approximately 30 min after awakening. Evidence suggests the function of the CAR may be related to arousal, energy boost and/or anticipation, although its precise function is still unknown. The CAR has been investigated in a range of clinical populations including the assessment of daytime dysfunction in insomnia; however little research, if any, has specifically examined its relation to sleep architecture, or night-time difficulties associated with insomnia. The aim of this review is to provide an overview of the CAR, a description of the factors which can affect it, and to outline the CAR in relation to the ‘3P’ model of insomnia. This review concludes with a description of a standard protocol for measurement of the CAR, which can be adapted and applied within sleep medicine.
AB - The stress hormone cortisol is the end product of the hypothalamic–pituitary–adrenal (HPA) axis, and the cortisol awakening response (CAR) refers to the rapid rise in cortisol levels observed immediately following awakening. During the CAR period, cortisol levels typically increase by 38%–75%, peaking approximately 30 min after awakening. Evidence suggests the function of the CAR may be related to arousal, energy boost and/or anticipation, although its precise function is still unknown. The CAR has been investigated in a range of clinical populations including the assessment of daytime dysfunction in insomnia; however little research, if any, has specifically examined its relation to sleep architecture, or night-time difficulties associated with insomnia. The aim of this review is to provide an overview of the CAR, a description of the factors which can affect it, and to outline the CAR in relation to the ‘3P’ model of insomnia. This review concludes with a description of a standard protocol for measurement of the CAR, which can be adapted and applied within sleep medicine.
KW - Cortisol awakening response
KW - stress
KW - insomnia
KW - hypothalamic–pituitary–adrenal axis
U2 - 10.1016/j.smrv.2013.05.001
DO - 10.1016/j.smrv.2013.05.001
M3 - Article
VL - 18
SP - 215
EP - 224
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
SN - 1087-0792
IS - 3
ER -