Salivary cortisol for monitoring circadian rhythm variation in adrenal activity during shiftwork

To examine the validity of salivary cortisol for monitoring circadian rhythm variation in adrenal activity during shiftwork, saliva and blood samples were collected at 4-h intervals in experimental short-term shifts, i.e., day (work 0830-1600 h; sleep 0030-0800 h), evening (work 1630-2400 h; sleep 0430-1200 h), and night (work 0030-0800 h; sleep 1230-2000 h) shifts over 2 days. Cortisol levels, determined by radioimmunoassay, and the circadian profiles of saliva and sera were compared. The salivary cortisol showed relatively low levels, the 2-day mean value being 3.1%-3.3% that of serum total cortisol through all shifts. Significant differences in the serum to saliva cortisol ratios were noted among shifts and subjects. When expressed as a relative percentage of a 2-day mean value, however, salivary cortisol paralleled the modified circadian profiles of serum total cortisol of the evening and night shifts, with no significant time lag and no difference in magnitude. The cosinor analysis supported this finding. Thus, salivary cortisol appears to be an excellent measure for monitoring circadian rhythm variation in adrenal activity in healthy individuals during shiftwork.