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Cortisol awakening response
The cortisol awakening response (CAR) is an increase of about 50% in cortisol levels occurring 20–30 minutes ''after'' awakening in the morning in some people. This rise is superimposed upon the late-night rise in cortisol which occurs ''before'' awakening. While its purpose is uncertain, it may be linked to the hippocampus' preparation of the hypothalamic-pituitary-adrenal axis (HPA) in order to face anticipated stress.
==Description==
Shortly after awakening, a sharp 38–75% (average 50%) increase occurs in the blood level of cortisol in about 77%〔 of healthy adults, and it occurs in people of all ages.〔Fries E, Dettenborn L, Kirschbaum C. (2009). The cortisol awakening response (CAR): facts and future directions. Int J Psychophysiol. 72(1):67–73. PMID 18854200〕 The average level of salivary cortisol upon waking is roughly 15 nmol/l; 30 minutes later it may be 23 nmol/l, though there are wide variations.〔Wüst S, Wolf J, Hellhammer DH, Federenko I, Schommer N, Kirschbaum C. (2000).(The cortisol awakening response – normal values and confounds. ) Noise Health. 2(7):79-88. PMID 12689474〕 The cortisol awakening response reaches a maximum approximately 30 minutes after awakening though it may still be heightened by 34% an hour after waking.〔 The pattern of this response to waking is relatively stable for any individual.〔〔Hucklebridge F, Hussain T, Evans P, Clow A. (2005). The diurnal patterns of the adrenal steroids cortisol and dehydroepiandrosterone (DHEA) in relation to awakening. Psychoneuroendocrinology. 30(1):51–7. PMID 15358442〕 Twin studies show its pattern is largely genetically determined since there is a heritability of 0.40 for the mean cortisol increase after awakening and 0.48 for the area under the cortisol rise curve.〔Wüst S, Federenko I, Hellhammer DH, Kirschbaum C. (2000). Genetic factors, perceived chronic stress, and the free cortisol response to awakening. Psychoneuroendocrinology. 25(7):707–20. PMID 10938450〕
Normally, the highest cortisol secretion happens in the second half of the night with peak cortisol production occurring in the early morning. Following this, cortisol levels decline throughout the day with lowest levels during the first half of the night.〔Tsigos C, Chrousos GP. (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 53(4):865–71. PMID 12377295〕 Cortisol awakening response is independent of this circadian variation in HPA axis activity; it is superimposed upon the daily rhythm of HPA axis activity; and it seems to be linked specifically to the event of awakening.〔Wilhelm I, Born J, Kudielka BM, Schlotz W, Wüst S. (2007). Is the cortisol awakening rise a response to awakening? Psychoneuroendocrinology. 32(4):358–66. PMID 17408865〕
Cortisol awakening response provides an easy measure of the reactivity capacity of the HPA axis.〔Schmidt-Reinwald A, Pruessner JC, Hellhammer DH, Federenko I, Rohleder N, Schürmeyer TH, Kirschbaum C. (1999). The cortisol response to awakening in relation to different challenge tests and a 12-hour cortisol rhythm. Life Sci. 64(18):1653–60. PMID 10328525〕
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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