From the Guidelines
A high cortisol awakening response indicates that the body is experiencing chronic stress or psychological strain, potentially leading to various health issues including cardiovascular problems and metabolic disorders. This response is closely linked to the body's natural surge in cortisol levels after waking up, which is more pronounced in individuals under ongoing stress 1. Some key points to consider about a high cortisol awakening response include:
- It is associated with work overload, worry about upcoming demands, depression, anxiety disorders, and burnout
- It can occur during acute periods of stress like exam preparation or work deadlines
- Physiologically, it represents the body's attempt to mobilize energy resources to meet anticipated challenges, as cortisol helps regulate metabolism, immune function, and the stress response
- Persistently high cortisol awakening response may eventually lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, contributing to health issues The relationship between cortisol and metabolic syndrome (MetS) has been demonstrated in various studies, including the one published in Circulation 1, which highlights the role of cortisol in mediating visceral fat accumulation, insulin resistance, and type 2 diabetes mellitus (T2DM). Key aspects of the metabolic syndrome linked to elevated cortisol include:
- Visceral obesity
- Accelerated and severe cardiovascular mortality
- Abdominal fat distribution
- Elevated blood pressure, fasting glucose, insulin, and waist circumference It is essential to consider these factors when evaluating the implications of a high cortisol awakening response on overall health and well-being.
From the Research
Cortisol Awakening Response
- A high cortisol awakening response (CAR) has been linked to various health outcomes, including stress and internalizing symptoms 2, 3, 4.
- The CAR is a distinct facet of the circadian cortisol rhythm, associated with arousal, energy boost, and/or anticipation, although its precise function is still unknown 5.
- Studies have shown that a higher CAR is associated with successful coping with same-day daily life stress 3 and attenuated distress responses to daily life stress 3.
- A high CAR has also been correlated with internalizing symptoms, such as depression and anxiety, in emerging adults 4.
- Factors that can affect the CAR include sleep, stress, and daily life hassles, with sleep insufficiency being a significant predictor of CAR magnitude 2.
- Meditation interventions have been shown to efficiently reduce cortisol levels, including CAR, in at-risk samples, such as patients with somatic illnesses or those living in stressful life situations 6.