Cortisol Awakening Response (CAR)

One of the tasks of the stress hormone cortisol is to supply the brain with energy (glucose) under stress.  Shortly after awakening, the cortisol level in the saliva increases by approximately 70%. This increase is altered under stress and what is helpful to the body in the short term can become a problem in the long term.
Complex feedback mechanisms change and result in subsequent damage such as disorders in metabolism, in the circulatory system and in well-being. The Cortisol Awakening Response (CAR) has established itself as a biomarker for chronic stress and specific stress-associated diseases.

Figure 1: The graphic represents a typically seen “normal” CAR, a blunted CAR (dotted line, hypocortisolism) and a hyperresponsive CAR (dashed line, hypercortisolism).

The prominent rise in cortisol directly after awakening is a well-researched biomarker on its own and as a component of the neuropattern stress diagnostics system. Cortisol rises are especially relevant for stress-related health disorders, but are not subjectively sensible. Therefore, the CAR is a relevant and objective indicator of stress, especially when the early recognition of stress symptoms is the goal.

The collection of saliva is carried out by the patient himself in his natural environment, thus having high ecological validity.

Figure 2: The graphic represents the delta of the CAR between clinic admission and discharge at four time points after awakening and for AVWF treated patients as well as their controls.

AVWF = Audio Visuelle Wahrnehmungsförderung (audio-visual awareness stimulation)