Day-to-day variation in saliva cortisol--relation with sleep, stress and self-rated health.

The objective was to examine the day-to-day variation in cortisol among healthy individuals and its relation to the time of saliva sampling, work, stress and fatigue. During 4 consecutive weeks, 14 office workers provided saliva samples (at awakening, 15 min after awakening and at bedtime) and made diary ratings for each day. Results showed a variation in cortisol values between participants but also within individuals. After controlling for the individual differences, results showed that low cortisol levels in the morning were associated with sleepiness at awakening and anxiety, exhaustion, and poor health the day before. High evening levels of cortisol were associated with symptoms of stress and poor self-rated health. Further analysis of the cortisol awakening response (CAR) showed that all participants had a mixture of both a positive and negative responses. During mornings with a negative response participants stayed in bed for a longer time after the initial awakening, which might be a sign of snoozing, thus missing the awakening response.