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Peer-reviewedCC BYClocks & sleep

Salivary Cortisol as a Biomarker of Sleep Quality: A Scoping Review.

  • Preyahathai Aroonvanichporn1
  • Poompat Thititanakul2
  • Krittapak Kwanmongkolpong2
  • Nicharat Sriratanasak3,4
  • Chanchai Boonla5
  • Chidsanu Changsiripun6
  • Nattida Chotechuang2
6 affiliations
  1. 1NIST International School, Bangkok 10110, Thailand.
  2. 2Department of Food Technology, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand.
  3. 3Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand.
  4. 4Center of Excellence in Cancer Cell and Molecular Biology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand.
  5. 5Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
  6. 6Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand.
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Abstract

Background

Sleep is a crucial regulator for physiological and psychological balance, and sleep disturbances have been associated with the hypothalamic-pituitary-adrenal (HPA) axis. Cortisol exhibits a circadian rhythm and plays a central role in stress response and metabolic regulation. Salivary cortisol has been widely used as a non-invasive biomarker for sleep quality, but its reflection remains unclear. This scoping review aims to systematically map and evaluate the existing literature on the relationship between salivary cortisol and sleep outcomes.Methods

Medline, Scopus, and Cochrane databases were applied to identify relevant studies. Database searches combined specific terms from three concept groups: cortisol, sleep quality, and biomarkers. This protocol follows the JBI guidelines. To be incorporated, records pertaining to any type of study design that mentions the use of salivary cortisol and the analysis of sleep quality were considered. Finally, 1067 studies were imported. Among those, 31 studies met eligibility criteria and were extracted.Result

The results indicated the trend in the use of salivary cortisol as a sleep quality biomarker; the study shows limited consistency as a biomarker. Its relationship with sleep outcomes is highly dependent on methodological factors and contextual influences.Conclusions

Overall, salivary cortisol may reflect broader stress-related physiological processes rather than sleep quality directly.

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Cite

BibTeXRIS
BibTeX
@article{aroonvanichporn2026salivary,
  title = {{Salivary Cortisol as a Biomarker of Sleep Quality: A Scoping Review.}},
  author = {Preyahathai Aroonvanichporn and Poompat Thititanakul and Krittapak Kwanmongkolpong and Nicharat Sriratanasak and Chanchai Boonla and Chidsanu Changsiripun and Nattida Chotechuang},
  journal = {Clocks \& sleep},
  year = {2026},
  month = oct,
  doi = {10.3390/clockssleep8040068},
  url = {https://europepmc.org/article/MED/42924744},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Salivary Cortisol as a Biomarker of Sleep Quality: A Scoping Review.
AU  - Preyahathai Aroonvanichporn
AU  - Poompat Thititanakul
AU  - Krittapak Kwanmongkolpong
AU  - Nicharat Sriratanasak
AU  - Chanchai Boonla
AU  - Chidsanu Changsiripun
AU  - Nattida Chotechuang
PY  - 2026
DA  - 2026/10/20
JO  - Clocks & sleep
DO  - 10.3390/clockssleep8040068
UR  - https://europepmc.org/article/MED/42924744
AB  - Background  Sleep is a crucial regulator for physiological and psychological balance, and sleep disturbances have been associated with the hypothalamic-pituitary-adrenal (HPA) axis. Cortisol exhibits a circadian rhythm and plays a central role in stress response and metabolic regulation. Salivary cortisol has been widely used as a non-invasive biomarker for sleep quality, but its reflection remains unclear. This scoping review aims to systematically map and evaluate the existing literature on the relationship between salivary cortisol and sleep outcomes.Methods  Medline, Scopus, and Cochrane databases were applied to identify relevant studies. Database searches combined specific terms from three concept groups: cortisol, sleep quality, and biomarkers. This protocol follows the JBI guidelines. To be incorporated, records pertaining to any type of study design that mentions the use of salivary cortisol and the analysis of sleep quality were considered. Finally, 1067 studies were imported. Among those, 31 studies met eligibility criteria and were extracted.Result  The results indicated the trend in the use of salivary cortisol as a sleep quality biomarker; the study shows limited consistency as a biomarker. Its relationship with sleep outcomes is highly dependent on methodological factors and contextual influences.Conclusions  Overall, salivary cortisol may reflect broader stress-related physiological processes rather than sleep quality directly.
SN  - 2624-5175
ER  -