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The cortisol awakening response: more than a measure of HPA axis function

Clow, Angela and Hucklebridge, Frank and Stalder, Tobias and Evans, Philip D. and Thorn, Lisa (2010) The cortisol awakening response: more than a measure of HPA axis function. Neuroscience & Biobehavioral Reviews, 35 (1). pp. 97-103. ISSN 0149-7634

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Official URL: http://dx.doi.org/10.1016/j.neubiorev.2009.12.011


In most healthy people morning awakening is associated with a burst of cortisol secretion: the cortisol awakening response (CAR). It is argued that the CAR is subject to a range physiological regulatory influences that facilitate this rapid increase in cortisol secretion. Evidence is presented for reduced adrenal sensitivity to rising levels of ACTH in the pre-awakening period, mediated by an extra-pituitary pathway to the adrenal from the suprachiasmatic nucleus (SCN). A role for the hippocampus in this pre-awakening regulation of cortisol secretion is considered. Attainment of consciousness is associated with 'flip-flop' switching of regional brain activation, which, it is argued, initiates a combination of processes: (1) activation of the hypothalamic adrenal (HPA) axis; (2) release of pre-awakening reduced adrenal sensitivity to ACTH; (3) increased post-awakening adrenal sensitivity to ACTH in response to light, mediated by a SCN extra-pituitary pathway. An association between the CAR and the ending of sleep inertia is discussed.

Item Type:Article
Research Community:University of Westminster > Life Sciences, School of
ID Code:7095
Deposited On:05 Jan 2010 10:35
Last Modified:16 Jul 2013 10:52

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