title: Salivary cortisol response to awakening in chronic fatigue syndrome.
abstract: BACKGROUND
  There is accumulating evidence of hypothalamic-pituitary-adrenal (HPA) axis disturbances in chronic fatigue syndrome (CFS). The salivary cortisol response to awakening has been described recently as a non-invasive test of the capacity of the HPA axis to respond to stress. The results of this test correlate closely with those of more invasive dynamic tests reported in the literature; furthermore, it can be undertaken in a naturalistic setting.
  
  
  OBJECTIVE
  To assess the HPA axis using the salivary cortisol response to awakening in CFS.
  
  
  METHODS
  We measured salivary cortisol upon awakening and 10, 20, 30 and 60 min afterwards in 56 patients with CFS and 35 healthy volunteers.
  
  
  RESULTS
  Patients had a lower cortisol response to awakening, measured by the area under the curve.
  
  
  CONCLUSIONS
  This naturalistic test of the HPA axis response to stress showed impaired HPA axis function in CFS.
authors.affiliation: Section of General Hospital Psychiatry, Division of Psychological Medicine, Guy's, King's and St Thomas' School of Medicine and Dentistry, London, UK.
authors.forename: Amanda D L
authors.initials: AD
authors.lastname: Roberts
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Trudie
authors.initials: T
authors.lastname: Chalder
authors.forename: Andrew
authors.initials: A
authors.lastname: Papadopoulos
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Cleare
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000150:complications / Q000378:metabolism; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D012463:Saliva / Q000378:metabolism*; D012737:Sex Factors; D012890:Sleep / Q000502:physiology*; D012907:Smoking; D013997:Time Factors
chemical_list: D006854:Hydrocortisone