Ho, Rainbow T. H.Rainbow T. H.HoFong, Ted C. T.Ted C. T.FongDr. CHAN Kar-pui, CaitlinCaitlinDr. CHAN Kar-puiChan, Cecilia L. W.Cecilia L. W.Chan2025-09-092025-09-092013Psychoneuroendocrinology, 2013, vol. 38(10), pp. 2337-2342.0306-45301873-3360http://hdl.handle.net/20.500.11861/25053Objective<br> This study examined the relationships between diurnal cortisol patterns and sleep behavior, social support, psychological factors, and perceived health status in breast cancer patients.<br> Methods<br> One hundred and eighty-one breast cancer patients completed a self-report questionnaire that combined the Hospital Anxiety and Depression Scale, the Yale Social Support Scale, and self-perceived measures of physical health, stress, sleep quality, total sleep hours, and time of awakening. Salivary cortisol was collected upon waking, at 1200 h, 1700 h, and 2100 h on two consecutive days. Multiple regression analysis was performed on the diurnal cortisol slope that was derived from slope analysis of the log-transformed cortisol data.<br> Results<br> Controlling for the initial cortisol level, a flatter diurnal cortisol slope was significantly associated with a later time of awakening, higher negative social support, poorer perceived health, poorer sleep quality, and shorter total sleep hours. Anxiety and depression were not significantly correlated with the slope.<br> Conclusions<br> The results indicate a subtle dysregulation in hypothalamic-pituitary-adrenal axis functioning in patients with highly negative social support, poor perceived health, poor sleep quality, a later time of awakening, and insufficient sleep hours.enPeer Reviewed Journal Article10.1016/j.psyneuen.2013.05.004