Abstract
Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis, and its production is increased mainly in stressful situations or in chronic disorders accompanied by stress enhancement. Altered cortisol concentrations have been reported in a number of neuropsychiatric diseases and sleep disorders. Cortisol concentrations have been measured using several methods, and in several matrixes, such as blood, saliva, and urine. However, lately, hair cortisol, for several reasons, has emerged as a promising biomarker of long-term retrospective HPA activation. Several experimental approaches for cortisol measurement with the corresponding concentration reference ranges and a summary of findings from scientific literature on this field are presented. There is evidence of a close relationship between HPA functional alteration and the development of neuropsychiatric disorders. Sleep disorders are the most common manifestation in several neuropsychiatric conditions, and have also been associated to cortisol alterations in both adults and children. Many studies indicate that hair cortisol constitutes a valuable tool for further contributing to existing data on salivary, plasma, or urinary cortisol concentrations in patients with sleep disorders.
Highlights
Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis
The role of diet and nutritional status, body mass index, pollution and drugs on cortisol accumulation in hair should need a careful analysis in order to shed new lights on possible confounding factors in its determination and data interpretation
We need studies to assess whether hair cortisol can reflect the effects of pharmacological and non-pharmacological interventions aimed to improve sleep quality
Summary
Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis. It is mainly secreted in reaction to stress, and plays a key role in normal physiology [1,2,3]. Plasma or serum cortisol reflects the amounts of total cortisol and not free cortisol, which is the biologically active form of the molecule [38] For these reasons, the cortisol level in blood or urine is primarily used to diagnose Cushing’s syndrome or Addison’s disease, both of which affect the production of cortisol by the adrenal glands and the corresponding increase in cortisol concentration in urine in these endocrinology disorders are observed at any time of the day and usually lack of daily rhythm. Hair is valued for its ability to reflect long periods of time with retrospective information on exposure to toxic substances [41] It has the advantages of detection over several months, noninvasive sampling, easy storage and great resistance to decomposition—unlike body fluids, for example. The primary search terms used were “hair”, “cortisol” AND “sleep”
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