Cortisol awakening response

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Cortisol Awakening Response

3D structure of cortisol

The cortisol awakening response (CAR) is a phenomenon observed in the field of chronobiology and endocrinology, characterized by an increase in cortisol levels occurring shortly after waking from sleep. This response is a part of the body's natural circadian rhythm and is thought to play a role in preparing the body for the demands of the day.

Physiology

Cortisol is a glucocorticoid hormone produced by the adrenal cortex in response to adrenocorticotropic hormone (ACTH) from the pituitary gland. The cortisol awakening response is typically measured by assessing cortisol levels in saliva at multiple time points after waking, usually at 0, 30, and 60 minutes post-awakening.

The CAR is distinct from the overall diurnal pattern of cortisol secretion, which typically peaks in the early morning and declines throughout the day. The specific increase in cortisol levels upon awakening is thought to be triggered by the transition from sleep to wakefulness and is influenced by factors such as light exposure, sleep quality, and individual differences in stress reactivity.

Function

The exact function of the cortisol awakening response is not fully understood, but it is believed to be involved in several physiological processes:

  • Energy Mobilization: The increase in cortisol levels helps to mobilize energy resources, preparing the body for physical and mental activity.
  • Immune Function: Cortisol has immunomodulatory effects, and the CAR may play a role in regulating immune function upon waking.
  • Cognitive Performance: Some studies suggest that the CAR is associated with improved cognitive performance and alertness in the morning.

Factors Influencing the CAR

Several factors can influence the magnitude and pattern of the cortisol awakening response:

  • Sleep Quality: Poor sleep quality or sleep disorders can alter the CAR.
  • Stress: Chronic stress and psychological stress can affect cortisol levels and the CAR.
  • Light Exposure: Exposure to natural or artificial light upon waking can influence the CAR.
  • Age and Gender: There are age-related changes in cortisol secretion, and some studies suggest gender differences in the CAR.

Clinical Implications

The cortisol awakening response has been studied in relation to various health conditions, including:

  • Depression: Altered CAR patterns have been observed in individuals with depression.
  • Chronic Fatigue Syndrome: Abnormal CAR has been reported in patients with chronic fatigue syndrome.
  • Burnout: Changes in the CAR have been associated with occupational burnout.

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Contributors: Prab R. Tumpati, MD