Cortisol-Awakening-Response-saliva Cortisol-Awakening-Response-saliva
Cortisol Awakening Response; saliva Cortisol Awakening Response; saliva Cortisol Awakening Response; saliva

Cortisol Awakening Response; saliva

The cortisol awakening response is the natural rise in cortisol that is seen 30 to 40 minutes after awakening followed by a noticeable drop by 60 minutes. CAR can be utilized as a biomarker for assessment of the HPA axis function in routine clinical practice. CAR is influenced by overall HPA reactivity, as well as a person’s anticipation of stress.

The CAR involves a measure of the percent rise in cortisol from awakening to 30 minutes post-awakening and the expected decline in cortisol seen at 60 minutes. The Diurnal Cortisol Profile involves 4 cortisol samples taken at 30 minutes post-awakening, noon, dinner time, and bedtime. While the CAR can provide the best information on HPA axis reactivity and function, the Diurnal Cortisol Profile can identify dysregulation in the natural cortisol circadian rhythm.

Useful for:

  • Feeling stressed 
  • Fatigue 
  • Insomnia 
  • Nervousness/Irritability 
  • Salt/Sugar cravings 
  • Dizzy spells 
  • Headaches 
  • Decreased stamina 
  • Burn out 
  • Chronic disease 
  • Anxiety/depression 

Turnaround Time

3 to 5 days

Note: Turnaround times on results are an estimate and are not guaranteed. The lab may need additional time due to holidays, confirmation/repeat testing, etc. You can contact us to discuss when your results should be ready.

Analytes Tested

Click any analyte name for additional clinical information, including reference ranges, specimen collection, stability and rejection criteria.

List price applies when filing with insurance or Medicare, or when billing a patient directly. Prompt payment pricing applies when billing to a physician account or prepayment is received with the test.

Doctor's Data offers profiles containing multiple analytes. *Multiple analytes may be billed under a single CPT code. Many analytes can be ordered individually. Pricing may vary. Click on a specific analyte for more information or read our detailed billing and payment policies.

The CPT codes listed on our website are for informational purposes only. This information is our interpretation of CPT coding requirements and may not necessarily be correct. You are advised to consult the CPT Coding Manual published by the American Medical Association. Doctor's Data, Inc. takes no responsibility for billing errors due to your use of any CPT information from our website.

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Detailed Information

Research has found that a lower cortisol response to awakening is often seen in individuals with:
• A high amount of psychosocial burnout
• Chronic fatigue
• Seasonal affective disorder (during winter)
• Nightshift work schedules
• Sleep apnea
• Short sleep cycles
• Chronic inflammation
• Adrenal insufficiency
• Lack of morning sunlight exposure
• Hippocampal damage or atrophy
• Amnesia (due to temporal lobe damage)

Factors associated with an elevated CAR include:
• Ongoing job-related and perceived stress (CAR is significantly higher on work days)
• Immediate access to light upon awakening
• Depression
• Ovulation phase of the menstrual cycle
• Sleep issues
• Older age

Cortisol levels should be at their highest level 30 minutes after waking up in the morning, decreasing gradually over the course of the day, reaching their lowest point at bedtime. The resulting diurnal curve or pattern allows health care providers to pinpoint issues with adrenal gland function. Alterations in this pattern can results in symptoms related to stress, fatigue and insomnia.