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Sleep disruption is a growing problem that may have serious health effects. As stress-induced increases in cortisol are thought to be a key adaptive process it is important to examine how this response is affected by sleep. The current study investigated the association of four sleep parameters (objective/subjectively measured sleep quality and quantity) and subsequent salivary cortisol reactivity (maximal change from baseline) to an experimental stressor in 53 healthy women. Objective actigraphy monitoring and self-report diaries were used to assess sleep. Results revealed that individuals with lower objective sleep quality (wake percentage during sleep) had a blunted response to the experimental stressor. No associations were found between cortisol reactivity and actigraphy-derived sleep quantity, or either of the self-reported sleep variables. Results are discussed with regard to the possible adverse health effects that may result from poor sleep quality and a blunted cortisol response to stress.

A heightened cortisol awakening response (CAR) is associated with adiposity in middle-aged men, but the causal significance of this effect is not known. We hypothesised that if disturbance in cortisol secretion is involved in the development of overweight and obesity, then it might be present in normal weight adults at increased risk of obesity on account of parental adiposity. The CAR and cortisol profile over the day were measured in 33 men and 62 women aged 18-25 years. Parental adiposity was assessed with figure ratings derived from the Contour Drawing Rating Scale, and these were correlated with parental self-reported body mass index (BMI) in a subset of participants (r=0.66-0.79). In men, a positive association was observed between the CAR and their judgements of their fathers' adiposity after controlling for age, smoking status, time of waking, and the participants' own BMI; the correlation was 0.56 (P=0.008) for the cortisol increase between waking and 30 min, and 0.47 (P=0.028) for the cortisol area under the curve. The correlation between the CAR and fathers' own reported BMI and figures ratings were also significant. The relationship between parental adiposity and the CAR in women was inconsistent, and the associations between the CAR and opposite gender parental adiposity were not significant. Parental adiposity was not related to cortisol output over the rest of the day or to the slope between waking and evening in either sex. The results of this study suggest that disturbances of cortisol secretion may present before the emergence of heightened adiposity in young men at raised risk for obesity.

Socioeconomic inequalities in morbidity and mortality exist, but the psychobiological pathways that link social status and health are less clear. It has previously been reported that socioeconomic status is inversely associated with the magnitude of the cortisol response to awakening (CAR) in men and women of working age. In the present study, we tested whether larger cortisol responses would be present in an older retired population, and whether the CAR differed between men and women. The extent to which adherence to saliva sample timing also affects the CAR was investigated. Ninety three men and women aged 65-80 years took saliva samples on waking, and then 10, 20, 30 and 60 min after waking. Subjective social status was assessed using the 'ladder' measure devised by Adler et al. (2000). Non-compliance was defined as a reported delay of 10 min or more between waking and taking the first saliva sample. Cortisol levels on waking were significantly higher in the non-compliant individuals, and the CAR was blunted compared with that of compliant participants. With non-compliant participants eliminated from the analyses, we found that low social status was associated with a larger CAR after adjusting for gender, waist/hip ratio, body mass index, smoking, time of waking, chronic illness, prescription medication, education and financial strain. No association was found between CAR and education or financial strain. Women also had significantly larger CARs, independent of socioeconomic position. The results highlight the importance of controlling for non-compliance and are consistent with the notion that higher socioeconomic position protects against stress-related activation of psychobiological pathways which may contribute to variation in disease risk evident in old age.

Abstract: Objective: Using an experimental paradigm this investigation explored whether exposure to psychological stress would produce a significant increase in acid-reflux episodes or modify subjective perceptions of gastro-oesophageal reflux (GOR) symptoms. Methods: Forty-two patients presenting with heartburn and acid regurgitation underwent 24-h oesophageal pH monitoring. During the last 90 min of this monitoring period, 21 patients received a psychological stressor, while the remaining participants were randomly assigned to a no-stress control condition. State anxiety and subjective GOR symptom ratings were obtained 1 min pretest, 1 min posttest, and 40 min posttest. Cortisol samples were collected at 10-min intervals. Results: The stressor induced a significant increase in cortisol and state anxiety; however, this was not associated with any increase in reflux. Instead, the experimental group reported a dissociation between objectively measured reflux episodes and subjective symptom ratings. A similar pattern was established for participants who reported greater state anxiety, produced larger cortisol responses, or exhibited certain stress-related personality characteristics. Conclusion: The perception of symptoms in the absence of increased reflux when one is stressed may account for low response rates to traditional treatments. This highlights a need to bridge the gap between psychosomatic research and clinical practice to develop more successful GOR therapies. [Copyright &y& Elsevier]