Professional Documents
Culture Documents
www.elsevier.com/locate/psyneuen
Free cortisol awakening responses are
inuenced by awakening time
Ilona Federenko
a,
, Stefan Wust
a
, Dirk H. Hellhammer
a
,
Ralph Dechoux
b
, Robert Kumsta
a
, Clemens Kirschbaum
c
a
Department of Clinical and Theoretical Psychobiology, University of Trier, Karl-Marx-Str. 9496,
54290 Trier, Germany
b
Department of Neurology and Sleep Research, Caritas Clinic, Werkstr. 3, 66763 Dillingen, Germany
c
Department of Experimental Psychology II, University of Dusseldorf, Universitatsstr. 1,
40225 Dusseldorf, Germany
Received 6 May 2002; received in revised form 19 November 2002; accepted 4 December 2002
Abstract
Psychobiological investigations on the hypothalamuspituitaryadrenal (HPA) axis depend
on markers that adequately describe the activity of this system. There is evidence that the free
cortisol response to awakening, proposed as a marker for the HPA axis, can be inuenced by
time of awakening. To further investigate this possible confounder, 24 shift working nurses
and 31 female students on a regular sleepwake cycle collected saliva samples 0, 30, 45 and
60 minutes after awakening. Nurses were investigated on the rst and second day of their
early (awakening: 04000530 h), late (awakening: 06000900 h), and night shift (awakening:
11001400 h), respectively. Students were studied after taking a short nap on two consecutive
weekdays (awakening: 18452030 h). Mean cortisol levels after awakening increased signi-
cantly under all three shift conditions (p0.01), but decreased in the student sample (p.05).
Within the three shift conditions, cortisol responses following waking in the early shift were
more pronounced than in late (p.01) and night shift (p.05). The present study shows that
in a sample with a large range of awakening times, an impact of this variable on the cortisol
awakening response can be observed. The data furthermore strongly suggest that waking up
per se is insufcient for adrenocortical stimulation.
2003 Elsevier Ltd. All rights reserved.
Keywords: Salivary cortisol; Cortisol awakening response; Awakening time; Circadian rhythm; Shift work