ArticleProceedings. Biological sciences2025
Awakening not associated with an increased rate of cortisol secretion.
Article in Proceedings. Biological sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cortisol levels and depression suicide risk: a combined exploration of meta-analysis and case-control study.Frontiers in psychiatry · 2025Pooled it
- Blunted Cortisol Awakening Response in Patients with Inflammatory Bowel Disease: A Cross-Sectional Case-Control Study.Medical sciences (Basel, Switzerland) · 2026Article
- Science with Seymour Levine: on glucocorticoid action from birth to senescence.Neurobiology of stress · 2026Article
- Wake Up and Smell-the Cortisol?The Journal of clinical endocrinology and metabolism · 2026Article
- Impact of exam stress and time of day on hand grip fatigue in medical students.Scientific reports · 2026Article
- Advances in Electrochemical Nanobiosensors for Noninvasive Stress Biomarker Detection.Sensors (Basel, Switzerland) · 2025Review
- Awakening not associated with an increased rate of cortisol secretion.Proceedings. Biological sciences · 2025Article
- The cortisol awakening response: Fact or fiction?Brain and neuroscience advancesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
Cortisol is released upon activation of the hypothalamic-pituitary-adrenal axis, varies across the day, possesses an underlying diurnal rhythm and is responsive to stressors. The endogenous circadian peak of cortisol occurs in the morning, and increases in cortisol observed post-awakening have been named the cortisol awakening response (CAR) based on the belief that the act of waking up stimulates cortisol secretion. However, objective evidence that awakening induces cortisol secretion is limited. We used a mixed effects model with a linear spline fitted to the data to examine tissue-free cortisol measurements obtained from 201 healthy volunteers by automated ambulatory microdialysis before and after awakening in their home environments. We also examined rate of change of cortisol depending on sleep duration and relative timing. We found no evidence for a change in the rate of cortisol increase in the hour after waking when compared with the hour prior to waking. We instead observed substantial interindividual variability in the absolute concentration and rate of change of cortisol levels, and differences in dynamics that may be attributable to duration and relative timing of sleep. Based on these results, we strongly suggest caution is needed when interpreting cortisol measurements solely obtained in the hour after waking.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.