Several daily measurements are necessary to reliably assess the cortisol rise after awakening: State-and trait components
Abstract
The cortisol rise after awakening (CAR) is a frequently applied measure of pituitary-adrenal activity. This measure seems to reflect the acrophase of the diurnal cycle and can easily be assessed in saliva samples, collected by the proband or patient under real life conditions. Since different state and trait factors affect the CAR, we here address the questions (a) to which extent state and trait factors affect the CAR, and (b) how often cortisol measures after awakening have to be taken to obtain reliable results. In this study, we assessed the CAR on 6 consecutive days. After applying structural equation models and correlation analyses, we conclude that (a) the CAR of a single day is determined to a great extent by situational factors and only for a small proportion by trait factors and (b) from two (AUC(t)) to six (AUC(i)) days are necessary to achieve reliable trait measures, since state factors bias data from a single day.
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The share of CAR variance that generalizes past the collection day is small, reported as 36-60% for AUC (baseline, 30, 45, and 60 minutes) and 15-37% for increase.
“As is true for other diurnal cortisol parameters (Segerstrom et al., 2014), the amount of variance in the CAR that generalizes beyond the day on which it was collected is small (36-60% for AUC [baseline, 30, 45, and 60 minutes]; 15-37% for increase; Hellhammer et al., 2007.)”
From Psychosocial functioning and the cortisol awakening response: meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies (2017) · cites this paper as Hellhammer et al., 2007
To measure the CAR reliably, sampling may need to extend over as many as six days.
“As a consequence, reliable measurement of the CAR can require sampling over up to 6 days (Hellhammer et al., 2007).”
From Psychosocial functioning and the cortisol awakening response: meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies (2017) · cites this paper as Hellhammer et al., 2007
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- Authors
- Hellhammer, J., Fries, E., Schweisthal, O. W., Schlotz, W., Stone, A. A., & Hagemann, D.
- Affiliations
- Universität Trier (DE)
- Stony Brook University (US)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2007-01
- Volume
- 32
- Issue
- 1
- Pages
- 80-86
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2109539558
- Cited by
- 540
- References
- 34
- Citations by year
- 2026: 13 · 2025: 13 · 2024: 13 · 2023: 11 · 2022: 17 · 2021: 20 · 2020: 22 · 2019: 34 · 2018: 31 · 2017: 36 · 2016: 39 · 2015: 40 · 2014: 34 · 2013: 46 · 2012: 36
- FWCI
- 8.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- diurnal cortisol rhythm, state factors, measurement reliability, salivary cortisol, acrophase, circadian rhythm
- MeSH terms
- Adult, Aged, Aged, 80 and over, Arousal, Circadian Rhythm, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Models, Psychological, Monitoring, Physiologic, Pituitary-Adrenal System, Saliva, Wakefulness
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