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The cortisol awakening response--applications and implications for sleep medicine.
Sleep Med Rev. 2014 Jun; 18(3):215-24.SM

Abstract

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.

Authors+Show Affiliations

Northumbria Centre for Sleep Research, School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK. Electronic address: greg.elder@northumbria.ac.uk.Northumbria Centre for Sleep Research, School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK.Northumbria Centre for Sleep Research, School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK.Northumbria Centre for Sleep Research, School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23835138

Citation

Elder, Greg J., et al. "The Cortisol Awakening Response--applications and Implications for Sleep Medicine." Sleep Medicine Reviews, vol. 18, no. 3, 2014, pp. 215-24.
Elder GJ, Wetherell MA, Barclay NL, et al. The cortisol awakening response--applications and implications for sleep medicine. Sleep Med Rev. 2014;18(3):215-24.
Elder, G. J., Wetherell, M. A., Barclay, N. L., & Ellis, J. G. (2014). The cortisol awakening response--applications and implications for sleep medicine. Sleep Medicine Reviews, 18(3), 215-24. https://doi.org/10.1016/j.smrv.2013.05.001
Elder GJ, et al. The Cortisol Awakening Response--applications and Implications for Sleep Medicine. Sleep Med Rev. 2014;18(3):215-24. PubMed PMID: 23835138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cortisol awakening response--applications and implications for sleep medicine. AU - Elder,Greg J, AU - Wetherell,Mark A, AU - Barclay,Nicola L, AU - Ellis,Jason G, Y1 - 2013/07/05/ PY - 2012/12/20/received PY - 2013/05/01/revised PY - 2013/05/01/accepted PY - 2013/7/10/entrez PY - 2013/7/10/pubmed PY - 2014/12/15/medline KW - Cortisol awakening response KW - Hypothalamic–pituitary–adrenal axis KW - Insomnia KW - Stress SP - 215 EP - 24 JF - Sleep medicine reviews JO - Sleep Med Rev VL - 18 IS - 3 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. SN - 1532-2955 UR - https://www.unboundmedicine.com/medline/citation/23835138/The_cortisol_awakening_response__applications_and_implications_for_sleep_medicine_ DB - PRIME DP - Unbound Medicine ER -