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Chauhan S, Norbury R, Faßbender KC, Ettinger U, Kumari V. Beyond sleep: A multidimensional model of chronotype. Neurosci Biobehav Rev 2023; 148:105114. [PMID: 36868368 DOI: 10.1016/j.neubiorev.2023.105114] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023]
Abstract
Chronotype can be defined as an expression or proxy for circadian rhythms of varied mechanisms, for example in body temperature, cortisol secretion, cognitive functions, eating and sleeping patterns. It is influenced by a range of internal (e.g., genetics) and external factors (e.g., light exposure), and has implications for health and well-being. Here, we present a critical review and synthesis of existing models of chronotype. Our observations reveal that most existing models and, as a consequence, associated measures of chronotype have focused solely or primarily on the sleep dimension, and typically have not incorporated social and environmental influences on chronotype. We propose a multidimensional model of chronotype, integrating individual (biological and psychological), environmental and social factors that appear to interact to determine an individual's true chronotype with potential feedback loops between these factors. This model could be beneficial not only from a basic science perspective but also in the context of understanding health and clinical implications of certain chronotypes as well as designing preventive and therapeutic approaches for related illnesses.
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Affiliation(s)
- Satyam Chauhan
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
| | - Ray Norbury
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom
| | | | | | - Veena Kumari
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
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2
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David MCMM, Vieira GR, Leôncio LMDL, Neves LDS, Bezerra CG, Mattos MSBD, Santos NFD, Santana FHD, Antunes RB, Araújo JF, Matos RJBD. Predictors of stress in college students during the COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 10:100377. [PMID: 35814812 PMCID: PMC9250709 DOI: 10.1016/j.jadr.2022.100377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/23/2022] [Accepted: 07/02/2022] [Indexed: 12/03/2022] Open
Abstract
Background College students experience high stress levels during emergency remote classes in the COVID-19 pandemic. However, it is not clear whether this is due to the summation effect of both stressors (classes and pandemic). Therefore, the aim of this study was to investigate predictors of stress in college students before and during remote classes five months after the beginning of the COVID-19 pandemic. Methods The study was conducted before (BRC, July-August 2020) and during remote classes (DRC, October-November 2020). The sample consisted of 177 individuals (80 in BRC, 97 in DRC). Students were asked to self-collect saliva for cortisol analysis at each moment of the study, and to fill out a form to characterize the individual and assess the chronotype (Morningness-Eveningness Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and the stress (Perceived Stress Scale–10). Results There was no difference between the evaluated periods for cortisol, perceived stress or sleep quality. Predictors for cortisol levels were gender, academic semester, chronotype, sleep quality and sadness due to pandemic (p<0.001). Limitations Short interval between BRC and DRC assessments of perceived stress and salivary cortisol. Conclusions Age, sex, income, academic semester, chronotype, and the impact of the pandemic on mood are predictors of stress among college students. In addition, emergency remote classes and sleep quality contribute to less perceived stress.
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Affiliation(s)
- Mírian Celly Medeiros Miranda David
- Posgraduate Program in Neuropsychiatry and Behavioral Sciences, Health Sciences Center, Federal University of Pernambuco, Recife, Brazil
- Neural Plasticity, Environment and Behavior Research Group, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Brazil
| | - Gilberto Ramos Vieira
- Physical Education and Sports Science Nucleus, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | - Lívia Maria de Lima Leôncio
- Physical Education and Sports Science Nucleus, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | - Letycia Dos Santos Neves
- Nutrition Nucleus, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | - Clécia Gabriela Bezerra
- Physical Education and Sports Science Nucleus, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | | | - Nataly Ferreira Dos Santos
- Neural Plasticity, Environment and Behavior Research Group, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Brazil
| | - Flávio Henrique de Santana
- Physical Education and Sports Science Nucleus, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Brazil
| | - Rodolfo Barbosa Antunes
- Department of Mathematics, Center of Exact and Natural Sciences, Federal University of Pernambuco, Recife, Brazil
| | | | - Rhowena Jane Barbosa de Matos
- Posgraduate Program in Neuropsychiatry and Behavioral Sciences, Health Sciences Center, Federal University of Pernambuco, Recife, Brazil
- Neural Plasticity, Environment and Behavior Research Group, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Avenida Carlos Amaral, 1015, Cajueiro, Santo Antônio de Jesus, Bahia 44574-490, Brazil
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Bowles NP, Thosar SS, Butler MP, Clemons NA, Robinson LD, Ordaz OH, Herzig MX, McHill AW, Rice SPM, Emens J, Shea SA. The circadian system modulates the cortisol awakening response in humans. Front Neurosci 2022; 16:995452. [PMID: 36408390 PMCID: PMC9669756 DOI: 10.3389/fnins.2022.995452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background In humans, circulating cortisol usually peaks 30–60 min after awakening from nocturnal sleep, this is commonly referred to as the cortisol awakening response (CAR). We examined the extent to which the CAR is influenced by the circadian system, independent of behaviors including sleep. Materials and methods We examined the CAR in 34 adults (20 female) using two complementary multiday in-laboratory circadian protocols performed in dim light, throughout which behavioral factors were uniformly distributed across the 24-hour circadian cycle. Protocol 1 consisted of 10 identical consecutive 5-hour 20-minute sleep/wake cycles, and protocol 2 consisted of 5 identical consecutive 18-hour sleep/wake cycles. Salivary melatonin was used as the circadian phase marker (0° = dim light melatonin onset). During each sleep/wake cycle, salivary cortisol was measured upon scheduled awakening and 50-minutes later, with the change in cortisol defined as the CAR. Cosinor analyses were used to detect any significant circadian rhythmicity in the CAR. In secondary analyses, we adjusted the models for time awake before lights on, total sleep time, percent of rapid eye movement (REM) sleep, and percent of non-rapid eye movement (NREM) sleep. Results Both protocols revealed a similar circadian rhythm in the CAR, with peaks occurring at a circadian phase corresponding to 3:40–3:45 a.m., with no detectable CAR during the circadian phases corresponding to the afternoon. In addition to the sinusoidal component of the circadian rhythm, total sleep time was also associated with the CAR for protocol 1. The percent of sleep spent in REM or NREM sleep were not associated with the CAR in either protocol. Conclusion Our results show that the CAR exhibits a robust circadian rhythm that persists even after adjusting for prior sleep. Presuming that the CAR optimizes physiological responses to the anticipated stressors related to awakening, these findings may have implications for shift workers who wake up at unusual circadian phases. A blunted CAR in shift workers upon awakening in the evening may result in diminished responses to stressors.
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Affiliation(s)
- Nicole P. Bowles
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: Nicole P. Bowles,
| | - Saurabh S. Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Knight Cardiovascular Institute, School of Medicine, Oregon Health and Science University, Portland, OR, United States
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
| | - Matthew P. Butler
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Noal A. Clemons
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - LaTroy D. Robinson
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Omar H. Ordaz
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Maya X. Herzig
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Andrew W. McHill
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
| | - Sean P. M. Rice
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
| | - Jonathan Emens
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- VA Portland Health Care System, Portland, OR, United States
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
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Lin YH, Jen HJ, Lin YK, Seo JD, Chang WP. Cortisol Awakening Response and Stress in Female Nurses on Monthly Shift Rotations: A Longitudinal Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9506583. [PMID: 36158880 PMCID: PMC9499772 DOI: 10.1155/2022/9506583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 09/01/2022] [Indexed: 11/18/2022]
Abstract
The majority of shift nurses are female, there is still an expectation that they fulfil the traditional role of women in the family in Asia, often conflicting with shift work, increases stress, and affects cortisol secretion patterns. This study was to understand the changes in the cortisol awakening response (CAR) and work stress in nursing personnel working in different shifts. We recruited 41 female shift nurses. We administered the Taiwan Nurse Stress Checklist (NSC), and the nurses themselves collected saliva samples upon waking and 30 minutes after waking for three consecutive days at home. The saliva samples enabled us to analyze the increase in cortisol levels following waking (CARi) of nurses working different shifts (day, evening, and night). We then analyzed the data obtained using a hierarchical linear model (HLM). The results indicated that in terms of stress from the inability to complete personal tasks, the regression coefficients of night-shift nurses vs. day-shift nurses (B = 4.39, p < .001) and night-shift nurses vs. evening-shift nurses (B = 3.95, p < .001) were positive, which means that night-shift nurses were under significantly greater stress than day-shift and evening-shift nurses. With regard to CARi, the regression coefficients of night-shift nurses vs. day-shift nurses (B = -3.41, p < .001) and night-shift nurses vs. evening-shift nurses (B = -2.92, p < .01) were negative, which means that night-shift nurses have significantly lower CARi values than day-shift and evening-shift nurses. With regard to cortisol levels 30 minutes after waking, the regression coefficients of night-shift nurses vs. day-shift nurses (B = -3.88, p < .01) and night-shift nurses vs. evening-shift nurses (B = -3.31, p < .01) were negative, which means that night-shift nurses have significantly lower cortisol levels 30 minutes after waking than day-shift and evening-shift nurses. These results indicate that female night-shift nurses display the lowest CARi and cortisol levels 30 minutes after waking and are more negatively affected by being unable to complete personal tasks.
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Affiliation(s)
- Yu-Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Ju Jen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Jang-Dong Seo
- Department of Statistics, Indiana University, Bloomington, USA
| | - Wen-Pei Chang
- Department of Nursing, Shuangho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Babilon S, Myland P, Klabes J, Simon J, Khanh TQ. Study protocol for measuring the impact of (quasi-)monochromatic light on post-awakening cortisol secretion under controlled laboratory conditions. PLoS One 2022; 17:e0267659. [PMID: 35584105 PMCID: PMC9116651 DOI: 10.1371/journal.pone.0267659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/11/2022] [Indexed: 11/21/2022] Open
Abstract
Cortisol secretion has a fundamental role in human circadian regulation. The cortisol awakening response (CAR) can be observed as a daily recurring sharp increase in cortisol concentration within the first hour after awakening and is influenced by environmental light conditions. The current work provides the study protocol for an ongoing research project that is intended to explore the spectral dependencies and to discuss measures of emotional state and cognitive functioning potentially related to the CAR. Based on a controlled within-subjects sleep laboratory study, the impact of a two-hour, (quasi-)monochromatic, post-awakening light exposure of different peak wavelength (applied from 6:00 to 8:00 am) on resulting CAR levels should be investigated in a systematic manner to eventually derive a corresponding spectral sensitivity model. As a secondary outcome, it should be explored whether a potentially light-enhanced cortisol secretion might also impact different measures of sleepiness, mood, and vigilance for certain wavelengths. The study protocol described in the present work discusses the various protocol steps using pilot data collected for two different wavelength settings (i.e., short-wavelength blue-light at λmax = 476 nm and long-wavelength red-light at λmax = 649 nm) experienced by a group of four healthy male adults at an average ± SD age of 25.25 ± 3.59 years.
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Affiliation(s)
- Sebastian Babilon
- Laboratory of Lighting Technology, Technical University of Darmstadt, Darmstadt, Germany
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul Myland
- Laboratory of Lighting Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Julian Klabes
- Laboratory of Lighting Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Joel Simon
- Laboratory of Lighting Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Tran Quoc Khanh
- Laboratory of Lighting Technology, Technical University of Darmstadt, Darmstadt, Germany
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6
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Cortisol and shiftwork: A scoping review. Sleep Med Rev 2021; 64:101581. [DOI: 10.1016/j.smrv.2021.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022]
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Tomorrow's gonna suck: Today's stress anticipation predicts tomorrow's post-awakening cortisol increase. Psychoneuroendocrinology 2019; 106:38-46. [PMID: 30953931 DOI: 10.1016/j.psyneuen.2019.03.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 02/14/2019] [Accepted: 03/21/2019] [Indexed: 12/18/2022]
Abstract
The cortisol awakening response (a rapid rise in cortisol concentration shortly after awakening) is hypothesized to prepare the organism to cope with upcoming demands, suggesting a key role for anticipatory stress in its regulation. Yet, no thorough test of this hypothesis incorporating temporal dynamics of the underlying processes has been conducted so far. To address this gap in the literature, the present study investigated the effects of anticipated stress for the next day (assessed in the evening) on an estimate of the cortisol awakening response (assessed in the following morning). In an ambulatory assessment paradigm, 42 participants (69% female; mean age = 22.8, range = 18-30 years) completed 5 consecutive days of assessments in their daily lives, collecting saliva samples at awakening and 30 min later. Using hierarchical linear modeling, associations with anticipatory stress were examined separately on the within- and between-person level. In line with our expectations, anticipatory stress predicted the post-awakening cortisol increase on the within-person level, implying an elevated cortisol rise on days for which more stress than usual had been anticipated. In contrast, on the between-person level higher average anticipatory stress did not predict an increased cortisol rise. Taken together, the findings confirm a key role of anticipatory stress in the regulation of the cortisol awakening response on the within-person level.
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Drezno M, Stolarski M, Matthews G. An in-depth look into the association between morningness–eveningness and well-being: evidence for mediating and moderating effects of personality. Chronobiol Int 2018; 36:96-109. [DOI: 10.1080/07420528.2018.1523184] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | | | - Gerald Matthews
- Institute for Simulation and Training, University of Central Florida, Orlando, USA
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9
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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10
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Vargas I, Lopez-Duran N. The cortisol awakening response after sleep deprivation: Is the cortisol awakening response a "response" to awakening or a circadian process? J Health Psychol 2017; 25:900-912. [PMID: 29076400 DOI: 10.1177/1359105317738323] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study tested whether the cortisol awakening response is dependent on the transition from sleep to awakening, or alternatively, a circadian-driven process that is independent of awakening. A total of 40 participants were randomly assigned to either a total sleep deprivation or a sleep condition. Salivary cortisol was also assessed. Participants in the sleep condition demonstrated a traditional cortisol awakening response, whereas participants in the total sleep deprivation condition showed no increases in morning cortisol. These results are consistent with the notion that if circadian-driven processes are related to the cortisol awakening response, they may only be activated when awakening occurs or is anticipated.
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Chiang JJ, Tsai KM, Park H, Bower JE, Almeida DM, Dahl RE, Irwin MR, Seeman TE, Fuligni AJ. Daily family stress and HPA axis functioning during adolescence: The moderating role of sleep. Psychoneuroendocrinology 2016; 71:43-53. [PMID: 27235639 PMCID: PMC5718343 DOI: 10.1016/j.psyneuen.2016.05.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 01/09/2023]
Abstract
The present study examined the moderating role of sleep in the association between family demands and conflict and hypothalamic-pituitary-adrenal (HPA) axis functioning in a sample of ethnically diverse adolescents (n=316). Adolescents completed daily diary reports of family demands and conflict for 15 days, and wore actigraph watches during the first 8 nights to assess sleep. Participants also provided five saliva samples for 3 consecutive days to assess diurnal cortisol rhythms. Regression analyses indicated that sleep latency and efficiency moderated the link between family demands and the cortisol awakening response. Specifically, family demands were related to a smaller cortisol awakening response only among adolescents with longer sleep latency and lower sleep efficiency. These results suggest that certain aspects of HPA axis functioning may be sensitive to family demands primarily in the context of longer sleep latency and lower sleep efficiency.
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Affiliation(s)
- Jessica J. Chiang
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,Corresponding author at: Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095, USA. (J.J. Chiang)
| | - Kim M. Tsai
- California State San Marcos, Department of Psychology, San Marcos, CA 92096, USA
| | - Heejung Park
- Bryn Mawr College, Department of Psychology, Bryn Mawr, PA 19010, USA
| | - Julienne E. Bower
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | - David M. Almeida
- Pennsylvania State University, Department of Human Development and Family Studies, University Park, PA 16802, USA
| | - Ronald E. Dahl
- University of California, Berkeley, Institute of Human Development, Berkeley, CA 94720, USA
| | - Michael R. Irwin
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA,University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Teresa E. Seeman
- University of California, Los Angeles, Division of Geriatrics, Los Angeles, CA 90095, USA
| | - Andrew J. Fuligni
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
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Devine JK, Wolf JM. Determinants of cortisol awakening responses to naps and nighttime sleep. Psychoneuroendocrinology 2016; 63:128-34. [PMID: 26441231 DOI: 10.1016/j.psyneuen.2015.09.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 11/25/2022]
Abstract
The cortisol awakening response (CAR) is a phenomenon describing the sharp increase in basal cortisol levels shortly after waking from sleep. While extensively studied, little is known about the role of sleep architecture contributing to CAR. Furthermore, the potential for CAR after a shorter bout of sleep--a nap--has not been directly investigated. The current studies thus aimed at assessed sleep duration, time of day, and sleep architecture as potential determinants of the cortisol awakening response. Saliva samples were collected during the first hour (0, 30, 45, 60 min) following several EEG-monitored laboratory sleep conditions. Those included afternoon naps wherein 17 participants (4 men; ages 18-26) napped for 50 min and 24 participants (11 men; ages 18-24) napped for 90 min. Furthermore, 20 participants (10 men; ages 18-35) visited the lab twice and in addition to staying overnight, napped 90 min in the morning either under placebo conditions or pharmacologically-manipulated sleep conditions (5mg Zolpidem). Cortisol increases were observed in response to each sleep condition except to 50-min afternoon naps. Furthermore, CARs were predicted by Stage 2 sleep when following nighttime sleep (r=.46, p=.04) and by Stage 1 sleep when following placebo morning naps (r=.54, p=.01). The current study established cortisol awakening responses to naps and implicates sleep duration and architecture in the generation of CAR to both napping and nighttime sleep. Assessing CAR in conjunction with the specific type of sleep may thus contribute to our understanding of mechanisms underlying positive and negative health effects of napping.
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13
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The cortisol awakening response – Applications and implications for sleep medicine. Sleep Med Rev 2014; 18:215-24. [DOI: 10.1016/j.smrv.2013.05.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/01/2013] [Accepted: 05/01/2013] [Indexed: 11/22/2022]
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Corbett BA, Schupp CW. The cortisol awakening response (CAR) in male children with autism spectrum disorder. Horm Behav 2014; 65:345-50. [PMID: 24508619 PMCID: PMC4004674 DOI: 10.1016/j.yhbeh.2014.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/29/2014] [Accepted: 01/31/2014] [Indexed: 10/25/2022]
Abstract
Our ability to adapt to change is fundamental. The cortisol awakening response (CAR) is a sharp rise in cortisol 30min after waking to help prepare an individual for ensuing stress. Children with autism spectrum disorder (ASD) often have difficulty adapting to change. Exploration of the CAR is warranted; yet, the few studies investigating it are inconclusive. The CAR was investigated in 94 pre-pubertal male children 8-to-12years of age with ASD (46) and typical development (TD, 48). Salivary samples were collected over three diurnal cycles involving two morning samples: M1: Immediately upon Waking and M2: 30-min Post Waking (M2-M1=CAR). The magnitude of the CAR was measured by independent two sample t-tests, variability was measured using Levene's Test, the sequence of the CAR was analyzed by a linear mixed-effects model and proportion of children exhibiting a CAR by chi-square test of independence. There were no significant differences on the CAR between the groups based on magnitude (t(92)=-0.14, p=0.89, d=0.04), variability (F(45,47)=1.11, p=0.72, η(2)=0.11) or the sequence over three days (F(2,88)=0.26, p=0.77, η(2)=0.01). No significant differences were shown in the proportion of children exhibiting a CAR across the groups based on child (χ(2)(1)=0.02, p=0.89) or adult criterion (χ(2)(1)=1.82, p=0.18). Despite group differences in the regulation and responsivity of cortisol, the CAR is indistinguishable between children with and without ASD. Inconsistencies across studies may be due to age, criterion used, and diagnostic distinctions.
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Affiliation(s)
- Blythe A Corbett
- Vanderbilt University, Department of Psychiatry, Nashville, TN, United States; Vanderbilt Kennedy Center, Nashville, TN, United States.
| | - Clayton W Schupp
- Cancer Prevention Institute of California, Fremont, CA, United States
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Hahm BJ, Jo B, Dhabhar FS, Palesh O, Aldridge-Gerry A, Bajestan SN, Neri E, Nouriani B, Spiegel D, Zeitzer JM. Bedtime misalignment and progression of breast cancer. Chronobiol Int 2013; 31:214-21. [PMID: 24156520 DOI: 10.3109/07420528.2013.842575] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Disruption of circadian rhythms, which frequently occurs during night shift work, may be associated with cancer progression. The effect of chronotype (preference for behaviors such as sleep, work, or exercise to occur at particular times of day, with an associated difference in circadian physiology) and alignment of bedtime (preferred vs. habitual), however, have not yet been studied in the context of cancer progression in women with breast cancer. Chronotype and alignment of actual bedtime with preferred chronotype were examined using the Morningness-Eveningness Scale (MEQ) and sleep-wake log among 85 women with metastatic breast cancer. Their association with disease-free interval (DFI) was retrospectively examined using the Cox proportional hazards model. Median DFI was 81.9 months for women with aligned bedtimes ("going to bed at preferred bedtime") (n = 72), and 46.9 months for women with misaligned bedtimes ("going to bed later or earlier than the preferred bedtime") (n = 13) (log rank p = 0.001). In a multivariate Cox proportional hazard model, after controlling for other significant predictors of DFI, including chronotype (morning type/longer DFI; HR = 0.539, 95% CI = 0.320-0.906, p = 0.021), estrogen receptor (ER) status at initial diagnosis (negative/shorter DFI; HR = 2.169, 95% CI = 1.124-4.187, p = 0.028) and level of natural-killer cell count (lower levels/shorter DFI; HR = 1.641, 95% CI = 1.000-2.695, p = 0.050), misaligned bedtimes was associated with shorter DFI, compared to aligned bedtimes (HR = 3.180, 95% CI = 1.327-7.616, p = 0.018). Our data indicate that a misalignment of bedtime on a daily basis, an indication of circadian disruption, is associated with more rapid breast cancer progression as measured by DFI. Considering the limitations of small sample size and study design, a prospective study with a larger sample is necessary to explore their causal relationship and underlying mechanisms.
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Affiliation(s)
- Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine , Stanford, CA , USA
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16
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Abstract
The cortisol awakening response (CAR) is a much studied but poorly understood aspect of the circadian pattern of cortisol secretion. A Scopus search of "cortisol" and "awakening" reveals 666 publications in this area since 1997 when it was first identified by Pruessner and colleagues as a "reliable biomarker of adrenocortical activity". The primary focus of the majority of these studies is centered on its utility as a biomarker associated with a range of psychosocial, physical and mental health variables. Such studies typically examine differences in the CAR (studied on 1 or 2 days) between healthy participants and other comparator groups of interest. Fewer studies (25 in our estimation) have examined correlates of day-to-day variation in the CAR in healthy participants, informing its role and regulation within the healthy circadian pattern of cortisol secretion. This is the first review to examine these studies which, although limited in number, offer a relatively coherent emerging story about state factors that influence the CAR and the impact of the CAR on daily functioning. Greater understanding of these issues helps illuminate the utility of the CAR as a promising biomarker in psychophysiological and epidemiological research. The review also highlights areas that require greater clarification and points to potentially fruitful areas of further research.
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Affiliation(s)
- Robin Law
- Department of Psychology, University of Westminster, London, UK
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17
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Klingenberg L, Chaput JP, Holmbäck U, Visby T, Jennum P, Nikolic M, Astrup A, Sjödin A. Acute Sleep Restriction Reduces Insulin Sensitivity in Adolescent Boys. Sleep 2013; 36:1085-1090. [PMID: 23814346 DOI: 10.5665/sleep.2816] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Short sleep duration has been linked to impaired glucose metabolism in many experimental studies. Moreover, studies have reported indications of an increased metabolic stress following sleep restriction. OBJECTIVE We aimed to investigate the effects of partial sleep deprivation on markers of glucose metabolism. Additionally, we aimed to investigate if short sleep duration induces a state of endocrine stress. DESIGN A randomized crossover design, with 2 experimental conditions: 3 consecutive nights of short sleep (SS, 4 h/night) and long sleep (LS, 9 h/night) duration. SUBJECTS AND MEASUREMENTS In 21 healthy, normal-weight male adolescents (mean ± SD age: 16.8 ± 1.3 y) we measured pre- and post-prandial glucose, insulin, C-peptide, and glucagon concentrations. Furthermore, we measured fasting cortisol, 24-h catecholamines, and sympathovagal balance. RESULTS Fasting insulin was 59% higher (P = 0.001) in the SS than the LS condition as was both fasting (24%, P < 0.001) and post-prandial (11%, P = 0.018) C-peptide. Pre- and post-prandial glucose and glucagon were unchanged between conditions. The homeostasis model assessment of insulin resistance (HOMA-IR) index was 65% higher (P = 0.002) and the Matsuda index was 28% lower (P = 0.007) in the SS condition compared to the LS condition. The awakening cortisol response and 24-h norepinephrine were not affected by sleep duration, whereas 24-h epinephrine was 24% lower (P = 0.013) in the SS condition. Neither daytime nor 24-h sympathovagal balance differed between sleep conditions. Short wave sleep was preserved in the SS condition. CONCLUSION Short-term sleep restriction is associated with decreased insulin sensitivity in healthy normal-weight adolescent boys. There were no indications of endocrine stress beyond this. CITATION Klingenberg L; Chaput JP; Holmbäck U; Visby T; Jennum P; Nikolic M; Astrup A; Sjödin A. Acute Sleep Restriction Reduces Insulin Sensitivity in Adolescent Boys. SLEEP 2013;36(7):1085-1090.
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Affiliation(s)
- Lars Klingenberg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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18
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Fekedulegn D, Burchfiel CM, Violanti JM, Hartley TA, Charles LE, Andrew ME, Miller DB. Associations of long-term shift work with waking salivary cortisol concentration and patterns among police officers. INDUSTRIAL HEALTH 2012; 50:476-486. [PMID: 23047078 PMCID: PMC4685453 DOI: 10.2486/indhealth.2012-0043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The objective of this study was to evaluate whether long-term shift work is associated with both the total hormonal secretion after awakening and the pattern of the cortisol levels during the first hour following awakening, among 65 randomly selected police officers who represent a high stress occupation. Dominant shift (Day, Afternoon, or Midnight) was ascertained using daily payroll records of each participant's work activities during the 6-8 yrs prior to saliva sampling. Four salivary samples were collected at 15 min intervals upon first awakening. After accounting for potential confounders, salivary cortisol concentrations averaged across all four time points and total area under the curve differed significantly across shift with midnight shift workers showing suppressed awakening cortisol response relative to the afternoon and day shift. The percent of hours worked on midnight shift was inversely correlated with total awakening cortisol output. In contrast, the pattern of cortisol secretion during the first hour following waking appeared not to be affected as no significant interaction effect was found between time since awakening and shift work. The results show that long-term midnight shift work is associated with decreased absolute mean level and total volume of cortisol released over the waking period.
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Affiliation(s)
- Desta Fekedulegn
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, USA.
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19
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Adan A, Archer SN, Hidalgo MP, Di Milia L, Natale V, Randler C. Circadian typology: a comprehensive review. Chronobiol Int 2012; 29:1153-75. [PMID: 23004349 DOI: 10.3109/07420528.2012.719971] [Citation(s) in RCA: 799] [Impact Index Per Article: 66.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The interest in the systematic study of the circadian typology (CT) is relatively recent and has developed rapidly in the two last decades. All the existing data suggest that this individual difference affects our biological and psychological functioning, not only in health, but also in disease. In the present study, we review the current literature concerning the psychometric properties and validity of CT measures as well as individual, environmental and genetic factors that influence the CT. We present a brief overview of the biological markers that are used to define differences between CT groups (sleep-wake cycle, body temperature, cortisol and melatonin), and we assess the implications for CT and adjustment to shiftwork and jet lag. We also review the differences between CT in terms of cognitive abilities, personality traits and the incidence of psychiatric disorders. When necessary, we have emphasized the methodological limitations that exist today and suggested some future avenues of work in order to overcome these. This is a new field of interest to professionals in many different areas (research, labor, academic and clinical), and this review provides a state of the art discussion to allow professionals to integrate chronobiological aspects of human behavior into their daily practice.
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Affiliation(s)
- Ana Adan
- Department of Psychiatry and Clinical Psychobiology, School of Psychology, University of Barcelona, Spain.
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20
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Hansen AM, Thomsen JF, Kaergaard A, Kolstad HA, Kaerlev L, Mors O, Rugulies R, Bonde JP, Andersen JH, Mikkelsen S. Salivary cortisol and sleep problems among civil servants. Psychoneuroendocrinology 2012; 37:1086-95. [PMID: 22208999 DOI: 10.1016/j.psyneuen.2011.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 12/05/2011] [Accepted: 12/06/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present study used information from a field study conducted among 4489 civil servants (70% women) in Denmark in 2007. The purpose was to examine the association between sleep problems and salivary cortisol by using a cross-sectional design with repeated measures in a subsample three-month later. METHODS Sleep problems during the past night and the past 4 weeks were assessed by a self-administered questionnaire on overall sleep quality, disturbed sleep, sleep length and awakening problems. Saliva samples were collected in a single day, using cotton tubes, 30 min after awakening and again at 2000 h. A subsample of 387 participants collected saliva samples three-month later at awakening, +20 min and +40 min after awakening and at 2000 h. We adjusted for confounders related to sampling time, life style and personal characteristics, socioeconomic status and work aspects. RESULTS Sleep problems during the past four weeks were associated with low morning and evening saliva cortisol concentrations: [-3.1% per score of disturbed sleep (p=.009); and -4.7% per score of awakening problems (p<.001)]. Whereas sleep problems were not related with slope (the morning to evening change in cortisol levels). Awakening problems predicted lower cortisol (-7.51% per score; p=.003) three-month later. Cortisol awakening response (CAR) and slope three-month later were significantly associated with disturbed sleep (-7.84% and -8.24%) and awakening problems (-6.93). Area under the curve (AUC(morning)) increased with disturbed sleep (3.77%). CONCLUSION Surprisingly, low morning cortisol was associated with increased sleep problems during a four-week period prior to sampling among 4066 Danish civil servants. At follow-up three-month later, those with sleep problems had a flattened cortisol profile. Those with awakening problems also had low salivary cortisol in general.
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Affiliation(s)
- Ase Marie Hansen
- The National Research Centre for Working Environment, Copenhagen, Denmark.
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21
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Lovell B, Moss M, Wetherell MA. With a little help from my friends: psychological, endocrine and health corollaries of social support in parental caregivers of children with autism or ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:682-7. [PMID: 22186636 DOI: 10.1016/j.ridd.2011.11.014] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 11/22/2011] [Accepted: 11/22/2011] [Indexed: 05/24/2023]
Abstract
Elevated psychological distress and concomitant dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated as one pathway that links the stress of caregiving with adverse health outcomes. This study assessed whether perceived social support might mitigate the psychological, endocrine and health consequences of caregiver stress in parents of children with autism and attention deficit hyperactivity disorder (ADHD). Parental caregivers completed measures of psychological distress, perceived availability of social support and physical health complaints. To capture important parameters of the basal diurnal cortisol pattern, caregivers collected salivary cortisol at waking, 30 min post waking, 1200 h and 2200 h on two consecutive weekdays. Psychological distress and self reported physical health complaints were inversely related to scores on all support subscales: tangible, belonging, self esteem and appraisal. Results further revealed a significant, positive association between magnitude of the cortisol awakening response (CAR) and caregivers' self esteem. As a buffer between the stress of caregiving and adverse physical health outcomes, social support acts to reduce stress appraisals and mitigate disturbances of the HPA axis. Moving forward, intervention programmes might seek to increase caregivers' perceived availability of social resources.
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Affiliation(s)
- Brian Lovell
- Department of Psychology, School of Life Sciences, Northumbria University, UK.
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22
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Figueiro MG, Rea MS. Short-wavelength light enhances cortisol awakening response in sleep-restricted adolescents. Int J Endocrinol 2012; 2012:301935. [PMID: 22899916 PMCID: PMC3413982 DOI: 10.1155/2012/301935] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 05/30/2012] [Indexed: 11/21/2022] Open
Abstract
Levels of cortisol, a hormone produced by the adrenal gland, follow a daily, 24-hour rhythm with concentrations reaching a minimum in the evening and a peak near rising time. In addition, cortisol levels exhibit a sharp peak in concentration within the first hour after waking; this is known as the cortisol awakening response (CAR). The present study is a secondary analysis of a larger study investigating the impact of short-wavelength (λ(max) ≈ 470 nm) light on CAR in adolescents who were sleep restricted. The study ran over the course of three overnight sessions, at least one week apart. The experimental sessions differed in terms of the light exposure scenarios experienced during the evening prior to sleeping in the laboratory and during the morning after waking from a 4.5-hour sleep opportunity. Eighteen adolescents aged 12-17 years were exposed to dim light or to 40 lux (0.401 W/m(2)) of 470-nm peaking light for 80 minutes after awakening. Saliva samples were collected every 20 minutes to assess CAR. Exposure to short-wavelength light in the morning significantly enhanced CAR compared to dim light. Morning exposure to short-wavelength light may be a simple, yet practical way to better prepare adolescents for an active day.
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Affiliation(s)
- Mariana G. Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, 21 Union Street, Troy, NY 12180, USA
- *Mariana G. Figueiro:
| | - Mark S. Rea
- Lighting Research Center, Rensselaer Polytechnic Institute, 21 Union Street, Troy, NY 12180, USA
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23
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Inslicht SS, Otte C, McCaslin SE, Apfel BA, Henn-Haase C, Metzler T, Yehuda R, Neylan TC, Marmar CR. Cortisol awakening response prospectively predicts peritraumatic and acute stress reactions in police officers. Biol Psychiatry 2011; 70:1055-62. [PMID: 21906725 PMCID: PMC3225122 DOI: 10.1016/j.biopsych.2011.06.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 05/17/2011] [Accepted: 06/20/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal axis is a major stress response system hypothesized to be involved in the pathogenesis of posttraumatic stress disorder (PTSD). However, few studies have prospectively examined the relationships among pre-exposure hypothalamic-pituitary-adrenal activity, acute stress reactions and PTSD. METHODS Two hundred ninety-six police recruits were assessed during academy training before critical incident exposure and provided salivary cortisol at first awakening and after 30 minutes. A measure of cortisol awakening response (CAR) was computed as the change in cortisol level from the first to the second collection. At 12, 24, and 36 months following the start of active police service, officers were assessed for peritraumatic distress, peritraumatic dissociation, acute stress disorder (ASD) symptoms, and PTSD symptoms to their self-identified worst duty-related critical incident. Mixed models for repeated measures were used to analyze the effects of CAR on the outcome variables pooled across the three follow-up assessments. RESULTS After controlling for time of awakening, first awakening cortisol levels, and cumulative critical incident stress exposure, CAR during academy training was associated with greater peritraumatic dissociation, β = .14, z = 3.49, p < .0001, and greater ASD symptoms during police service assessed at 12, 24, and 36 months, β = .09, Z = 2.03, p < .05, but not with peritraumatic distress, β = .03, z = .81, p = .42, or PTSD symptoms, β = -.004, z = -.09, p = .93. CONCLUSIONS These findings suggest that greater cortisol response to awakening is a pre-exposure risk factor for peritraumatic dissociation and ASD symptoms during police service.
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Affiliation(s)
- Sabra S. Inslicht
- San Francisco VA Medical Center, San Francisco, CA
,University of California, San Francisco, CA
| | | | - Shannon E. McCaslin
- San Francisco VA Medical Center, San Francisco, CA
,University of California, San Francisco, CA
| | - Brigitte A. Apfel
- San Francisco VA Medical Center, San Francisco, CA
,University of California, San Francisco, CA
| | | | - Thomas Metzler
- San Francisco VA Medical Center, San Francisco, CA
,Northern California Institute for Research and Education, San Francisco, CA
| | - Rachel Yehuda
- Mount Sinai School of Medicine, New York, NY
,James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Thomas C. Neylan
- San Francisco VA Medical Center, San Francisco, CA
,University of California, San Francisco, CA
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24
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Wirth M, Burch J, Violanti J, Burchfiel C, Fekedulegn D, Andrew M, Zhang H, Miller DB, Hébert JR, Vena JE. Shiftwork duration and the awakening cortisol response among police officers. Chronobiol Int 2011; 28:446-57. [PMID: 21721860 DOI: 10.3109/07420528.2011.573112] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Police officers are required to work irregular hours, which induces stress, fatigue, and sleep disruption, and they have higher rates of chronic disease and mortality. Cortisol is a well-known "stress hormone" produced via activation of the hypothalamic-pituitary-adrenal axis. An abnormal secretion pattern has been associated with immune system dysregulation and may serve as an early indicator of disease risk. This study examined the effects of long- and short-term shiftwork on the cortisol awakening response among officers (n = 68) in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) pilot study (2001-2003). The time each officer spent on day (start time: 04:00-11:59 h), afternoon (12:00-19:59 h), or night (20:00-03:59 h) shifts was summarized from 1994 to examination date to characterize long-term (mean: 14 ± 9 yrs) and short-term (3, 5, 7, or 14 days prior to participation) shiftwork exposures. The cortisol awakening response was characterized by summarizing the area under the curve (AUC) for samples collected on first awakening, and at 15-, 30-, and 45-min intervals after waking. Data were collected on a scheduled training or off day. The cortisol AUC with respect to ground (AUC(G)) summarized total cortisol output after waking, and the cortisol AUC with respect to increase (AUC(I)) characterized the waking cortisol response. Officers also completed the Center for Epidemiologic Studies Depression scale. Waking cortisol AUC values were lower among officers working short-term night or afternoon shifts than day shifts, with maximal differences occurring after 5 days of shiftwork. The duration of long-term shiftwork was not associated with the cortisol awakening response, although values were attenuated among officers with more career shift changes.
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Affiliation(s)
- Michael Wirth
- Department of Epidemiology and Biostatistics and South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
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25
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Sleep habits, alertness, cortisol levels, and cardiac autonomic activity in short-distance bus drivers: differences between morning and afternoon shifts. J Occup Environ Med 2011; 53:806-11. [PMID: 21701400 DOI: 10.1097/jom.0b013e318221c6de] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate sleep, alertness, salivary cortisol levels, and autonomic activity in the afternoon and morning shifts of a sample of short-distance bus drivers. METHODS A sample of 47 bus drivers was evaluated. Data regarding subjects and working characteristics, alertness (psychomotor vigilance task), sleep habits (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Actigraphy), endocrine stress response (salivary cortisol), and autonomic activity (heart-rate variability) were collected. RESULTS Sleep restriction was highly prevalent. Drivers in the morning shift slept 1 hour less than those in the afternoon shift, showed lower reaction time performance, a flattening of cortisol morning-evening difference, and higher overweight prevalence. CONCLUSIONS The differences found between morning and afternoon shifts point out to the need of the implementation of educational strategies to compensate the sleep loss associated with an early work schedule.
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26
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Cortisol awakening response - Are sampling delays of 15minutes acceptable? Int J Psychophysiol 2011; 82:202-5. [DOI: 10.1016/j.ijpsycho.2011.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 08/08/2011] [Accepted: 08/15/2011] [Indexed: 11/23/2022]
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27
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Dockray S, Steptoe A. Chronotype and diurnal cortisol profile in working women: differences between work and leisure days. Psychoneuroendocrinology 2011; 36:649-55. [PMID: 20950941 DOI: 10.1016/j.psyneuen.2010.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 09/15/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022]
Abstract
The influence of chronotype on the diurnal profile of salivary cortisol was examined in a sample of 187 healthy women: 21 evening chronotype, 24 morning chronotype and 142 intermediate chronotype. Saliva samples were collected at waking, 30 min post-awakening, at 1000 h, 1200 h, 1500 h, 1700 h and at bedtime on one work and one leisure day. Several components of the diurnal profile were examined including the cortisol awakening response, the total cortisol output and the diurnal profile on both the work and the leisure day, a significant main effect of time emerged (both p<0.01). After adjustment for age, smoking status, self-rated health, time of waking, and sleep problems, no effect of chronotype was evident for cortisol in the evening, the cortisol awakening response, or total cortisol output over the working day. However, on the leisure day, total cortisol output was greater in evening-types than intermediate or morning-types, after adjustment for covariates (p=0.029). The present data indicate that chronotype has a limited impact on the diurnal cortisol profile of healthy women, and may be somewhat impervious to individual preferences for morning or evening activity.
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Affiliation(s)
- Samantha Dockray
- Department of Epidemiology and Public Health, University College London, London, UK.
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28
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Okun ML. Biological Consequences of Disturbed Sleep: Important Mediators of Health? JAPANESE PSYCHOLOGICAL RESEARCH 2011; 53:163-176. [PMID: 23620604 DOI: 10.1111/j.1468-5884.2011.00463.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There is an extensive literature regarding the immunological and endocrinological consequences of illness, stress, and psychopathology. Yet only a modest literature is available regarding the potential unfavorable effects of chronic sleep loss/disruption on immune and endocrine pathways or on various aspects of health. Given that humans spend approximately 1/3 of their lives asleep, it seems pertinent to evaluate this necessary yet understudied behavior. The evidence overwhelmingly indicates that "excessive" sleep disruption or poor sleep quality/continuity may subsequently increase risk for adverse health outcomes, as well as mortality. This is thought to occur through dysregulation of biological pathways. While our information addressing the immunological or endocrinological consequences of poor sleep is mounting, the majority of evidence stems from epidemiologic and cross-sectional studies. The immune and endocrine systems are dynamic and constantly in flux. Thus, the methodologies and study designs used to understand how sleep affects these systems needs to be as dynamic. Experimental manipulations and longitudinal evaluations are needed to effectively understand sleep as a risk factor for health. Thus, this paper is a primer in which to highlight the immunological and endocrinological consequences of disrupted or disturbed sleep as well as describe how these relationships may impact overall health. It is also meant to spark an interest for future evaluations of how the behavior of sleep is relevant to health.
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29
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Aubry JM, Jermann F, Gex-Fabry M, Bockhorn L, Van der Linden M, Gervasoni N, Bertschy G, Rossier MF, Bondolfi G. The cortisol awakening response in patients remitted from depression. J Psychiatr Res 2010; 44:1199-204. [PMID: 20471032 DOI: 10.1016/j.jpsychires.2010.04.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 04/14/2010] [Accepted: 04/14/2010] [Indexed: 10/19/2022]
Abstract
An impressive number of data has been accumulated on dysfunctions of the hypothalamo-pituitary-adrenal (HPA) axis and cortisol hypersecretion in depression. To assess the dynamic HPA functioning, the cortisol awakening response (CAR) is an easily accessible and reliable approach. Some data suggest that elevated CAR in depressed patients has trait-like characteristics. Therefore we investigated whether patients in remission from a depressive episode have elevated CAR compared to control subjects. CAR of thirty-eight patients in remission from depression (11 men, 27 women, age range 24-66) and 52 control participants were analyzed (18 men, 34 women, age range 24-63). All patients had experienced ≥3 previous depressive episodes and were off psychotropic medication since at least 3 months. Saliva samples were collected only once, at home, either on weekend or weekday at 0, 15, 30, 45 and 60 min post-awakening. The area under the curve (AUC) above minimum cortisol concentration displayed large interindividual variability (6.4-fold in remitted patients and 8.1-fold in controls, based on 80% range). Investigation of possible variability factors showed that percent explained variance increased from 3.9% when group was considered alone to 8.8%, 12.3% and 19.2% after adjusting for significant effects of weekday vs. weekend, wake-up time and sleep duration, respectively. According to the latter model, AUC was estimated to be 51% higher in remitted patients than in controls (p = 0.007), while a 21% AUC decrease was associated with a 1-h longer sleep duration (p<0.001). In future studies, detection of between-group differences might benefit from adjusting for sleep duration and other possible confounders.
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Affiliation(s)
- Jean-Michel Aubry
- Department of Psychiatry, Geneva University Hospital, Bipolar Program, 6-8 rue du 31 Décembre, 1207 Geneva, Switzerland.
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30
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Griefahn B, Robens S. The normalization of the cortisol awakening response and of the cortisol shift profile across consecutive night shifts--an experimental study. Psychoneuroendocrinology 2010; 35:1501-9. [PMID: 20570446 DOI: 10.1016/j.psyneuen.2010.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 04/14/2010] [Accepted: 05/07/2010] [Indexed: 11/29/2022]
Abstract
This study tested the hypothesis that the cortisol awakening response (CAR) and the cortisol shift profile normalize with successive night shifts due to the shift of the circadian system. 18 students (9 women, 9 men, 19-29 years), worked first four consecutive morning- and then four consecutive night shifts. Each work shift was preceded by an 8-h sleep opportunity meaning that the sleep-activity cycle was advanced by 8 h. The advance of the circadian system was promoted by a 2-h bright light pulse at the end of each night shift and quantified by 24-h phase assessment procedures (PA) before and after the four day shifts and again after the four night shifts. Saliva samples were taken 0, 15, 30, 45, and 60 min post-awakening, hourly during each work shift and each PA. During the night shift sequence, the CAR, indicated by the area under curve with respect to increase (AUC(I)), increased gradually across the 4-day sleep periods. Baseline levels were reached after 3 days in men and 4 days in women. The increase of the CAR was associated with a gradually increasing decline of cortisol levels during the night shifts. This adjustment was--at least not only--related to the advance of the circadian system which was 5 h. A contributor to the increase of the CAR might be the anticipation of the upcoming demands of the following work shifts.
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Affiliation(s)
- Barbara Griefahn
- Leibniz Centre for Working Environment and Human Factors at TU Dortmund (Leibniz-Institut für Arbeitsforschung and der TU Dortmund), Ardeystr. 67, 44139 Dortmund, Germany.
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Morningness–eveningness, habitual sleep-wake variables and cortisol level. Biol Psychol 2010; 85:14-8. [DOI: 10.1016/j.biopsycho.2010.04.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2009] [Revised: 02/27/2010] [Accepted: 04/22/2010] [Indexed: 11/18/2022]
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Preuss D, Schoofs D, Schlotz W, Wolf OT. The stressed student: influence of written examinations and oral presentations on salivary cortisol concentrations in university students. Stress 2010; 13:221-9. [PMID: 20235829 DOI: 10.3109/10253890903277579] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Laboratory research has demonstrated that social-evaluative threat has an influence on the hypothalamus pituitary adrenal axis (HPA). In two studies using independent samples, we evaluated the anticipatory cortisol response to a written university examination (n = 35) and to an oral presentation (n = 34). Saliva samples were collected before and after the examinations and on a control day. Additionally, saliva samples were collected on the day before the written examination and a control day. Results revealed significantly elevated cortisol concentrations on the day prior to the examination; however, this effect occurred only in those participants who had their control day after the examination. Cortisol concentrations were elevated on the examination day, with increased concentrations before but not after the examination. For the oral presentation study, the results revealed substantially elevated cortisol concentrations before and after the oral presentation. Taken together the results indicate that written examinations cause a mild anticipatory HPA response while oral presentations induce a strong HPA response. These findings appear to support the idea that social-evaluative threat is an important factor determining the size of the HPA response to laboratory stressors as well as to real-life stressors.
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Affiliation(s)
- Diana Preuss
- Department of Cognitive Psychology, Ruhr-University Bochum, Universitätsstr 150, D-44780 Bochum, Germany
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Abstract
BACKGROUND Dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis is thought to underlie stress-related psychiatric disorders such as posttraumatic stress disorder (PTSD). Some studies have reported HPA-axis dysregulation in trauma-exposed (TE) adults in the absence of psychiatric morbidity. In this dissertation we set out to unravel part of the mechanism that underlies the complex relations between trauma exposure, stress regulation, and psychopathology. METHOD Mentally healthy TE subjects were compared with non-trauma-exposed (NE) healthy controls. To distinguish between the potential effects of childhood trauma and adulthood trauma, we included women exposed to childhood trauma as well as men who were exposed to trauma during adulthood. Basal HPA-axis functioning was assessed with salivary cortisol samples. HPA-axis reactivity was assessed with the dexamethasone/corticotropin-releasing hormone (Dex/CRH) test. RESULTS The results show that childhood trauma exposure is associated with an attenuated cortisol response after the Dex/CRH challenge test in women. In contrast, trauma exposure during adulthood was not associated with alterations in HPA-axis regulation after the Dex/CRH test. Neither childhood trauma nor adulthood trauma were associated with basal HPA-axis functioning. CONCLUSION Childhood trauma rather than adulthood trauma may chronically affect HPA-axis functioning. Since the association between adulthood trauma and resilience to psychopathology cannot be explained by HPA-axis functioning alone, other factors must play a role.
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Alterations of the cortisol quiescent period after experimental night work with enforced adaptation by bright light and its relation to morningness. Eur J Appl Physiol 2009; 108:719-26. [DOI: 10.1007/s00421-009-1282-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
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Brosnan M, Turner-Cobb J, Munro-Naan Z, Jessop D. Absence of a normal cortisol awakening response (CAR) in adolescent males with Asperger syndrome (AS). Psychoneuroendocrinology 2009; 34:1095-100. [PMID: 19304400 DOI: 10.1016/j.psyneuen.2009.02.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 01/20/2009] [Accepted: 02/17/2009] [Indexed: 10/21/2022]
Abstract
In addition to abnormalities in social and communication development, a 'need for sameness' and 'resistance to change' are features of autistic spectrum disorders first identified by Kanner in 1943. Our ability to react to change is modulated by the hypothalamic-pituitary-adrenal (HPA) axis, a feature of which is a dramatic increase in cortisol upon waking, the Cortisol Awakening Response (CAR). This study examined whether the CAR was evident in 20 adolescent males with Asperger Syndrome (AS) and 18 age-matched typically developing (TD) controls (aged 11-16). Whilst a significant CAR was evidenced in the TD control group, this was not the case for those with AS. A normal diurnal decrease in cortisol, however, was evident in both groups. The implication that individuals with AS may have an impaired response to change in their environment due to a refractory HPA axis is discussed.
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Affiliation(s)
- Mark Brosnan
- Department of Psychology, University of Bath, Bath BA2 7AY, UK.
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Meissner K, Enck P, Muth ER, Kellermann S, Klosterhalfen S. Cortisol levels predict motion sickness tolerance in women but not in men. Physiol Behav 2009; 97:102-6. [PMID: 19419665 DOI: 10.1016/j.physbeh.2009.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Revised: 02/03/2009] [Accepted: 02/04/2009] [Indexed: 11/25/2022]
Abstract
A variety of intrinsic and extrinsic factors contribute to motion sickness severity in a stressful motion environment. The interplay of all these factors may partially explain the high inter-subject variability of motion sickness susceptibility found in many studies as well as some of the contradictory findings between studies regarding the modulating influence of single factors. We investigated the role of endogenous cortisol levels, gender and repetitive experience for motion sickness susceptibility. Motion sickness was induced in 32 healthy, but motion-sickness susceptible volunteers (16:16 males:females), by means of a vection drum. Subjects were investigated between 8:00 am (high cortisol) and 11:00 am (low cortisol), and on five consecutive days. Tolerance to rotation (RT) of the drum, motion sickness symptom ratings (SR) and salivary cortisol levels were assessed. Baseline cortisol levels correlated positively with RT in women, but not in men. RT showed a gender-specific time course across days, with higher values in males than in females on day 1, and sensitization on day 3 only in men. SR and cortisol levels following rotation did not differ between males and females, or between testing days. Gender differences in motion sickness susceptibility appear to be linked to a different role of basal cortisol levels for motion sickness tolerance. Results clearly indicate the need to control for gender, day time and cortisol levels in studies of motion sickness.
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Affiliation(s)
- K Meissner
- Institute for Medical Psychology, Ludwig-Maximilians-University Munich, Germany
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