Observational study uncovers heightened post-awakening cortisol secretion in chronically stressed workers, suggesting cortisol morning surges serve as a biomarker of chronic work overload.
The present study investigated the association between chronic stress and cortisol changes during the first hour after awakening in the morning. According to results of a pilot study, it was hypothesized that chronically stressed subjects would show a more enhanced and prolonged increase of cortisol level after awakening compared to non-stressed subjects. In 100 subjects, chronic stress was assessed twice with a 1-week interval between measures and cortisol was repeatedly measured during the first hour of awakening on 3 consecutive days. Results showed that chronically stressed subjects had a significantly larger increase in cortisol (+15.5 nmol/l) compared to unstressed subjects (+9.1 nmol/l). Further analysis indicated a significant sex difference with larger increases in chronically stressed women (+16.5 nmol/l) compared to stressed men (+11.8 nmol/l). From these data we conclude that a repeated measurement of free cortisol in response to awakening should be considered a possible biological correlate of chronic stress. Possible causes, consequences and clinical relevance of this hypercortisolism in chronically stressed subjects are briefly discussed.
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Schulz et al. (1998) studied this question.
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