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Concordance between Self-Reported and Objective Wakeup Times in Ambulatory Salivary Cortisol Research

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Abstract

Background

Hypothalamic–pituitary–adrenal (HPA) axis functioning has implications for physical and mental health. One important indicator of HPA axis functioning, the salivary cortisol awakening response (CAR), is sensitive to whether participants provide their samples at the requested times after waking.

Purpose

To examine the extent to which adolescents report morning wakeup times accurately, test the impact of inaccurate waketime reporting on compliance with a salivary cortisol sampling protocol designed to estimate the CAR, and to examine the implications of non-compliance for CAR estimates.

Method

In a sample of 91 late adolescents, objective waketimes determined using actigraphy were compared to self-reported waketimes. Associations between accuracy of waketimes and compliance with requested morning cortisol sampling timings (wakeup and 30 min post-awakening) were examined, as were implications of non-compliance for the size of the CAR.

Results

In terms of accuracy, 72% of self-reported waketimes were within 5 min and 90% were within 15 min of objective waketimes. Individuals who were more than 5 min discrepant in their waketime reporting, however, had a 90% decrease in their likelihood of being compliant—taking both morning cortisol samples within the requested time frames after waking. However, CARs were significantly lower only among individuals whose subjective and objective waketimes differed by more than 15 min.

Conclusions

Self-reported waketimes were reasonably accurate when compared to objective estimates of time of waking. When available, however, estimates of compliance are improved by knowledge of objective waketimes, resulting in increased accuracy of CAR estimates.

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Notes

  1. Level of neuroticism did not predict either compliance or waketime discrepancy.

  2. Activity counts (A) within each epoch were calculated based on activity levels during the adjacent 2-min period two epochs using the following algorithm: \( A = E - 2\left( {{1 \mathord{\left/{\vphantom {1 {25}}} \right.} {25}}} \right) + E - 1\left( {{1 \mathord{\left/{\vphantom {1 5}} \right.} 5}} \right) + E + E + 1\left( {{1 \mathord{\left/{\vphantom {1 5}} \right.} 5}} \right) + E + 2\left( {{1 \mathord{\left/{\vphantom {1 {25}}} \right.} {25}}} \right) \). Threshold set to 40, with a range from 20 to 80.

  3. Negative values are presumed to be the result of slight differences between participants’ home clocks and the clocks on the computer where actigraphy data were downloaded.

Abbreviations

CAR:

Cortisol awakening response

HPA:

Hypothalamic–pituitary–adrenal

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Authors and Affiliations

  1. Department of Human Development and Social Policy, School of Education and Social Policy and Cells to Society Center, Institute for Policy Research, Northwestern University, 2120 Campus Drive, Evanston, IL, 60208, USA

    Amy S. DeSantis, Emma K. Adam & Leah D. Doane

  2. Feinberg School of Medicine, Department of Psychiatry, Division of Psychology and Behavioral Sciences, Northwestern University, Chicago, IL, USA

    Kathryn A. Mendelsohn

Authors
  1. Amy S. DeSantis
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  2. Emma K. Adam
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  3. Kathryn A. Mendelsohn
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  4. Leah D. Doane
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Corresponding author

Correspondence to Amy S. DeSantis.

Additional information

This research was conducted with the support of NIMH R01 MH65652 (R.E.Z., S.M., M.G.C., Principal Investigators), William T. Grant Scholars Award (E.K.A.), and a graduate fellowship from the Institute for Policy Research (A.S.D.).

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DeSantis, A.S., Adam, E.K., Mendelsohn, K.A. et al. Concordance between Self-Reported and Objective Wakeup Times in Ambulatory Salivary Cortisol Research. Int.J. Behav. Med. 17, 74–78 (2010). https://doi.org/10.1007/s12529-009-9053-5

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  • DOI: https://doi.org/10.1007/s12529-009-9053-5

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