Cortisol morning anxiety

Tips for Coping with Morning Anxiety

Given the stress of living through a pandemic, moderate anxiety is common. Waking up in a panic every morning is more troubling, as it sets in before coping mechanisms can be deployed. Morning anxiety has a biological cause: Cortisol, often called the “stress hormone,” is higher during the first hour after waking for people experiencing stress. Sometimes people feel a measure of control when they worry, so they have trouble stopping the cycle.

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Symptoms of and Myths About Anxiety

Many people conflate stress and anxiety, but they’re different. Webster’s defines anxiety as “being uneasy, apprehensive or worried about what may happen,” whereas stress is “mental or emotional tension or strain characterized by feelings of anxiety, fear, etc.” Stress can also be defined as not having the resources to complete a task, while anxiety is usually tied to a perceived threat, real or imagined. Stress may be alleviated by accomplishing the task, but anxiety sticks around, producing a host of physical and psychological symptoms.

Symptoms of Anxiety

Some of the symptoms commonly associated with anxiety are internally physical in nature, which can range from nausea and headache to rapid heart rate and tight chest. Other symptoms are outwardly physical, such as sweating, shaking or having difficulty breathing. There are also symptoms tied to behavioral or emotional tendencies, such as a sense of panic, difficulty concentrating, restlessness and diminished sex drives. Other potential symptoms are fatigue or problems sleeping.

Common Misconceptions About Anxiety

Unfortunately, there are several myths regarding anxiety and how it’s handled. Some prominent misconceptions include worrying is genetic and incurable, anxiety medication is addictive, using distractions or avoiding stressful situations can help minimize the threat of anxiety, and being around supportive people can cure anxiety.

Prevalence of Anxiety

Anxiety has been on the rise the last few years, as 32% of Americans say they’re more anxious than they were the year before. In 2019, two-thirds of Americans were worried about the safety of themselves and their families as well as their finances. Nearly two-thirds had anxiety about their health, and around half were worried about the effects of politics and had anxiety over various interpersonal relationships.

Ongoing anxiety can cause a variety of physical ailments, such as hypertension (high blood pressure), kidney and heart damage and arrhythmia. It can also exacerbate other conditions, such as depression, irritable bowel syndrome, asthma, heart disease, stroke and chronic pain.

General Anxiety Disorder

While occasional worry is a part of life, frequent excessive anxiety about tasks or situations that most people don’t find threatening could be an indication of generalized anxiety disorder (GAD). Nearly 7 million adult Americans experience GAD annually, per the Anxiety and Depression Association of America. Studies also indicate GAD affects women about twice as often as it affects men. Additionally, people with serious or painful medical conditions or substance misuse problems are more likely to have anxiety disorders.

Everyday Anxiety vs. GAD

An individual experiencing everyday anxiety will spend time worrying about a specific event, assignment, or task. They’ll also have trouble sleeping or concentrating during stressful times, and they’ll experience physical aches and pains from specific situations.

An individual with GAD will experience ongoing general worry about vague, often imagined threats that interfere with daily life. They’ll also experience frequent trouble sleeping or concentrating and experience physical aches and pains for more than six months without a specific cause.

Tips for Reducing Morning Anxiety

If a racing heart or upset stomach greets you first thing in the morning, you can do a few things to help ease your everyday anxiety. For instance, you can engage in exercise, which increases endorphins, improves mental focus, and elevates mood. You can also practice meditation or mindfulness, which can improve ability to calm the mind and stop the cycle of anxious thoughts.

Another tip involves limiting stressors, such as waiting to check news or social media, using an alarm clock instead of a smartphone, or taking the time to self-care. Additionally, you can use tactics designed to exert a sense of control, such as daily planning or writing down and “fact-checking” nagging fears. Finally, resources like meditation apps or podcasts focused on decreasing feelings of isolation can be valuable.

Reaching Out Can Help

If anxiety is impacting your sleep, work, relationships or ability to focus, seek professional help. The National Alliance on Mental Illness connects people with professionals in their area. Call 800-950-NAMI or text “NAMI” to 741741. If anxiety is causing suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Sources

https://www.psychiatry.org/newsroom/apa-public-opinion-poll-annual-meeting-2019

https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad/symptoms

https://adaa.org/sites/default/files/July%2015%20GAD_adaa.pdf

https://adaa.org/understanding-anxiety/myth-conceptions

https://www. frontiersin.org/articles/10.3389/fpsyg.2019.01684/full

https://www.glamour.com/story/if-youre-waking-up-with-anxiety-youre-not-alone

https://www.healthline.com/health/anxiety/effects-on-body#1

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml

https://www.womenshealth.gov/mental-health/mental-health-conditions/anxiety-disorders

https://www.psychologytoday.com/ca/blog/stroke-awareness/202008/can-i-ease-anxiety-practicing-mindfulness

8 Steps to Calm Morning Anxiety

Waking up with anxiety is common and often caused by a spike in cortisol levels.
To calm morning anxiety, eat a healthy breakfast high in magnesium-rich foods like oatmeal.
You should also avoid caffeine, get active, and establish a morning routine to mitigate anxiety.

Nearly everyone will experience some feelings of stress or anxiety at some point in their lives.

On a daily basis, that stress or anxiety is often felt most heavily in the morning. When you wake up, the pressure of completing the day's tasks may feel overwhelming, and biologically, your hormones can make that stress feel worse.

Here's what you need to know about morning anxiety and how to manage stress when you wake up.

Why do I wake up with anxiety?

Feeling anxious in the morning is common for people with and without anxiety disorders, says Mayra Mendez, PhD, a licensed psychotherapist.

Although there's not a lot of research specific to morning anxiety, many mental health practitioners see it in their practice. Oftentimes, putting a name to the condition is helpful.

"Many people are comforted to know there is a syndrome, and that what they are experiencing is not unique to them," says Moe Gelbart, PhD, the director of Behavioral Health at Torrance Memorial Medical Center.

Symptoms of morning anxiety

A racing heart
Shallow or rapid breathing
A feeling of dread or inability to get up and start the day
Difficulty concentrating
Fatigue

What causes morning anxiety?

Thinking about everything you have to accomplish during the day, from work to exercise and even socializing, can contribute to the anxiety that you feel in the morning, Mendez says.

While thinking about the day ahead might be stressful on its own, there's a biological process at play too: the Cortisol Awakening Response (CAR).

Cortisol is known as the stress hormone because it is involved in the body's response to stress. During the first 30 to 45 minutes that you are awake each day, cortisol levels spike, a phenomenon known as CAR, which can make you feel more stressed in the morning.

While anyone can experience morning anxiety, people with anxiety disorders are particularly susceptible.

"If you're already prone to anxiety, there can be a high level of anxiousness during the morning," Mendez says.

And while anxiety might be useful to get healthy individuals thinking about how to manage their day, it's likely to be more paralyzing for people with underlying anxiety disorders.

"The effect of higher cortisol further exacerbates physiological symptoms of anxiety such as increased adrenaline flow, increased heart rate, and increased blood pressure," Mendez says. "For someone with anxiety, when cortisol levels are higher in the morning, the anxiety is greater and interferes with the person's ability to think calmly and plan for the day ahead."

How to calm anxiety in the morning

To manage your stress or anxiety in the morning, you can try these strategies:

1.

Acknowledge the anxiety

Acknowledging your morning anxiety allows you to take steps to address it, rather than accepting it as an unavoidable part of your life.

"Recognizing a problem and its source is the first step in giving it proper attention and toward improving," Gelbart says.

Knowing that there's a biological contribution can also make it easier to face, Mendez says.

2.

Eat breakfast

Low blood sugar in the morning, which is common after not eating all night, can cause symptoms like sweating and negative feelings that may mimic anxiety.

Tasha Holland-Kornegay, PhD, a counselor, recommends incorporating foods with magnesium, which have been shown to help reduce anxiety.

"It would be wise to include, daily, some of the food choices that are high in this mineral," she says.

You can find magnesium in plenty of breakfast-friendly foods, including:

Nuts like almonds, cashews and hazelnuts

Bran cereals and other whole grains, like those in whole grain toast and oatmeal
Fish, including smoked salmon

Gelbart says that eating a nutritious breakfast soon after waking can also help you take control of anxiety and ease symptoms.

"In general, good and healthy eating habits is one of the tools to cope with anxiety," he says. "It is important because anxiety is a sense of losing control, and having things we can control help ease the fear."

3.

Be cautious of caffeine

Some research indicates that people with anxiety disorders are particularly susceptible to the effects of caffeine, which is believed to worsen the symptoms of anxiety.

"Caffeine promotes and increases anxiety," Gelbart says. You may want to limit your morning coffee intake or avoid it altogether. Gelbart recommends switching to decaf coffee or black tea, or sipping a glass of lemon water in the morning instead.

4. Try exercise

Regular exercise helps to regulate your central nervous system, and can help reduce your anxiety.

Exercising in the morning can be particularly beneficial. However, you don't have to exercise bright and early if you're not a morning person — engaging in regular exercise at any time is associated with a lower risk for anxiety.

One 2020 study found that exercises that incorporate mindfulness can be particularly helpful for managing anxiety. If you're experiencing morning anxiety, you should try:

Yoga. "Think about the breathing," Mendez says. "That puts an interruption to the negative thoughts for the moment. It can help reduce anxiety and calm your thoughts, and then the body can relax."
Tai Chi. This martial art incorporates breathing and movement, and can be beneficial for the same reasons as yoga.
Walking. Just 10 minutes of brisk walking can improve mood, a 2018 study found.

5.

Practice relaxation techniques

If you want a calmer morning, it's important to incorporate these mindfulness and relaxation techniques:

Get up early enough. Rushing will make you feel more stressed and anxious. Getting up a bit earlier will help you feel in control of your morning and give you time to take steps to prevent anxiety, like eating breakfast and exercising.
Take 5 minutes to meditate. Even a five minute meditation can reduce anxiety, according to one 2015 study. Not sure how to start morning meditation? Check out our beginner's guide to meditation.
Limit TV and social media. Watching TV news has been linked to more anxiety, as has social media use. If you want background noise, opt for classical music, which can reduce anxiety and boost wellbeing.

6. Follow a morning routine

Morning anxiety can make it difficult to get up and out. Having a solid routine for the first two hours of the day allows you to get your day started and interrupt the negative thoughts swirling in your head, Mendez says.

A routine may also help you feel more in control, which can reduce feelings of anxiety. In addition, "repetition is soothing," says Holland-Kornegay.

Your routine should incorporate the steps that can reduce morning anxiety. For example:

Wake up and make breakfast. Ease into your morning with a calming, nutritious start. Try oatmeal with fruit and nuts, which contains plenty of magnesium.
Exercise or practice mindfulness. Go for a 10-minute walk, or meditate for 5 minutes. You can even practice walking meditation to do both at once.
Shower. Take a relaxing, steamy cleanse after your exercise or meditation. You can also listen to classical music or your favorite calming tune.
Get ready. Prepare to work from home or commute with plenty of time to spare, so you're not in a rush or stressed about time constraints.

7. Get better sleep

Avoiding morning anxiety can also start with getting better sleep the night before. This is particularly common for people who have anxiety disorders — about 50% to 80% of people with mental health troubles have issues sleeping.

"Many people with anxiety have difficulty falling asleep thinking about issues, wake up very early and continue to ruminate," Gelbart says. "The lack of proper and good sleep raises their anxiety level as well."

Everyone should aim for 7 to 9 hours of sleep each night. That can be difficult for people with anxiety, since stress, anxiety, and insomnia are closely linked.

Establishing good sleep hygiene can help. This includes:

Going to sleep and getting up at the same time every day
Avoiding screens in the leadup to bedtime
Doing relaxing activities before bed, like taking a warm bath or reading a book

8. Seek treatment

Finally, if you believe you have an underlying anxiety disorder, or if your morning anxiety begins to interfere with your ability to function, you should also seek treatment from a mental health professional.

Therapy, behavioral changes, and medication can all help manage morning anxiety, but cognitive behavioral therapy (CBT) is particularly useful. Speaking with any licensed mental health professional — including a psychiatrist, psychologist, or professional counselor — can help, Gelbart says.

"Make sure they are experienced in the treatment of anxiety, and most helpful if they have expertise in cognitive behavioral therapy," Gelbart says.

Insider's takeaway

Morning anxiety is a common experience. However, you don't have to live with it. Lifestyle changes like eating a healthy breakfast, exercising regularly, getting better sleep, and practicing mindfulness can all help calm feelings of anxiety in the morning.

Overall, Gelbart recommends what he calls "STEM" to patients with morning anxiety. That stands for sleep, thinking, eating, and movement.

"All are important in general well-being, and in reducing levels of stress, which reduce anxiety. On a physical level, they help put the body in optimal equilibrium, and they also increase the sense of empowerment and control, which is important in dealing with anxiety," Gelbart says.

Kelly Burch

Kelly Burch is a New Hampshire-based freelance journalist writing about finances, health, family, and more. Her work has appeared in The Washington Post, The Chicago Tribune, and Forbes, among others. Follow her on Facebook or Twitter, and or learn more here.

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Where does morning anxiety come from?

Wake up and instead of joyful anticipation, you feel a grim certainty that something bad is definitely going to happen today? Anxiety wakes up even before the alarm goes off and stays on all morning without stopping for a minute? It's most likely the stress hormone cortisol. Its peak occurs in the first 30-45 minutes after waking up: it is cortisol that helps us maintain a state of wakefulness. If the morning alarm clock coincides with our internal clock, most likely our body produces just enough cortisol to wake up and immerse ourselves in work. If, day after day, we are forced to wake up at a time when our circadian clock is deep into the night, most likely, the level of stress is constantly elevated. And sooner or later it breaks through with a feeling of anxiety, tension and serious stress. The best advice, of course, is to try to synchronize the daily routine with your internal clock, but if this is not possible, then we advise you to try at least anti-stress practices to reduce anxiety and reduce cortisol levels safely.

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How to calm morning anxiety?

Eat breakfast

Seriously, a hearty, healthy breakfast can really help. As a rule, in the mornings we have low blood sugar, and this condition, in turn, can cause anxiety, increased sweating, and even negative thoughts.

It is also useful to include foods rich in magnesium in your morning meal: this mineral is known to reduce anxiety and strengthen the nervous system. Nuts, especially almonds, cashews and hazelnuts, whole grains, and fish are all rich in magnesium and are great for breakfast.

Limit caffeine

Caffeine can exacerbate anxiety symptoms, so people who are constantly experiencing stress should avoid foods and drinks that contain it altogether, or at least significantly reduce their amount. And remember that there is a lot of caffeine not only in coffee, but also in tea, including green tea. Have a glass of milk instead!

Exercise

A short sports warm-up is the best way to relieve stress, strengthen the nervous system and reduce anxiety symptoms. It's great if there is an opportunity to do morning exercises on the street or at least on the balcony: morning sunlight is amazingly beneficial for both physical and mental health. And yet - it activates the metabolism and all day we eat less and burn more calories.

Walk part of the way to work

A ten-minute brisk walk is enough to improve your mood and reduce symptoms of stress and anxiety. However, if you want to walk longer, who will forbid you.

Try meditation

If you know how to meditate, then a five-minute session in the morning will be enough to relieve anxiety and stress and meet the new day fully equipped. If you have not yet mastered this useful skill, then just try to relax for a few minutes, focus on breathing and imagine something as pleasant as possible: a forest, a seashore, a forest lake.

Do not read the news in the morning

Habitual morning routine: reading the news feed with a cup of morning coffee? If you care about your mental health, give up both. Social networks and news portals are an additional source of stress (even if, more than expected, they show pleasant news), you should not overload your nervous system.

Stick to your usual routine

The more predictable our lives are, the less stress we have. And if we cannot influence global events in any way, then it is quite possible to make our little world stable. Start your own morning routine and try to follow it steadily and consistently - you yourself will be surprised how calming it is.

Monitor your sleep

The better we sleep at night, the lower our stress levels in the morning and afternoon. If you have insomnia or wake up at night and then cannot fall asleep, do not hesitate to see a doctor - sleep disorders are easier to correct in the early stages. If there are no serious violations, try to go to bed and get up at the same time, give up gadgets in the last hour before going to bed, sleep in a dark and cool bedroom - and be calm and cheerful in the morning!

shift work

Shift work is an integral part of modern society and is found in many areas of human activity. A large number of studies have been carried out to assess the health status of workers of various professions with shift work, the results of which are summarized in review articles [1, 2]. The formation of a wide range of disorders of body functions caused by desynchronosis and the negative impact of stress, including disorders of the functional state of the nervous system and mental health, was found. In addition, the disruption of sleep-wakefulness and working capacity was accompanied by changes in the metabolic and hormonal status and an increased risk of developing obstructive sleep apnea syndrome, cardiovascular diseases, metabolic syndrome, diabetes mellitus, and even led to the development of certain forms of malignant neoplasms.

The youth environment is a specific social group with the presence of a daytime educational process and episodes of night sleep deprivation. Acquired in youth, the negative stereotype of behavior with night wakefulness is often reinforced when choosing shift work. The initial symptoms of physiological disorders in adolescence may be various complaints about the quality of sleep and daytime sleepiness [3]. Regular shift work is typical for medical students, as it is an integral part of the educational process. This group of young people often has circadian rhythm disturbances in the form of sleep quality disturbances in a negative psychological state [4–6]. Students of non-medical specialties are characterized by irregular episodes of sleep deprivation, associated both with negative behavioral stereotypes, such as “snacking” [7], and with work at night. The impact of irregular shift work is rarely considered in publications due to the lack of pronounced clinical consequences of the impact on health and relative well-being in students in this group. Perhaps the systematic nature of even irregular wakefulness at night can have a negative impact on the organization of biorhythms and psychological state.

The purpose of this work is to study anxiety, self-assessment of sleep and indicators of morning and evening levels of cortisol and salivary antioxidant activity in students with experience of occasional shift work.

Material and methods

We examined 159 students of Stavropol universities aged 17 to 22 years. Based on the survey, two groups were formed: 46 students with shift work experience made up the main group, 113 students who denied having such experience entered the control group.

Peculiarities of the psycho-emotional status of students were determined using the Eysenck personality questionnaire [8], the Spielberger-Khanin anxiety self-assessment scale [8], the Taylor Personality Anxiety Scale (modified by T.A. Nemchina) [9] and solving the stress problem [10 ]. Sleep self-assessment was carried out using the express questionnaires “Quality of sleep hygiene” and “Quality of sleep”, developed on the basis of questionnaires for the subjective assessment of sleep quality [7, 11, 12] and the Epworth sleepiness scale [13]. Biochemical parameters were assessed in the morning and evening. Oral fluid was collected using a specialized SaliCaps kit from 7:00 to 11:00 and from 16:00 to 20:00 and frozen at –20°C.

The research was carried out on the basis of the Research Laboratory "Nanobiotechnology and Biophysics" of the NCFU. The level of salivary free cortisol was determined by enzyme immunoassay using reagent kits from DBC (Canada) and DRG (Germany) on a Varioskan Flash multimodal reader (Thermo Fisher Scientific, USA). The total antioxidant activity was studied by the amperometric method by the equivalent of gallic acid on a TsvetYauza 01-AA instrument (Khimavtomatika, Russia).

The obtained data were processed using the Statistica 10.0 program. The Shapiro–Wilk test was used to evaluate the variation series and analyze the correspondence between the distribution types, and the Mann–Whitney test was used to compare groups. Data are presented as median and interquartile range (25th and 75th percentiles) — Me [P ₂₅ ; P ₇₅] respectively.

Results

Students of the control group had a stable psycho-emotional state with a satisfactory self-assessment of sleep (see table). Psychoemotional status and quality of sleep in students with and without shift work experience Note. * — statistically significant differences between students with shift work experience and control, p<0.05. The results of testing according to the Eysenck questionnaire revealed the predominance of persons with the manifestation of extraversion, while the level of neuroticism indicated emotional stability in the students of this group. Psychoticism in the majority of students without shift work experience practically did not manifest itself and was below average. Indicators on the personal scale of manifestations of anxiety Taylor changed in the range of average values, and reactive and personal anxiety on the scale of self-assessment Spielberger-Khanin in the majority was low. The obtained results of the assessment of the emotional status were consistent with the data of testing the resistance to psychological stress (the "stress" task). In this test, students were asked to determine their reaction to the described situations. In the control group respondents, the results corresponded to the average indicators of resistance to stress. All test results indicated an emotionally balanced state in students with no night shift experience.

According to self-assessment of sleep, no disturbances were detected in the control group. The indicators corresponded to quality sleep with observance of sleep hygiene, without pronounced daytime sleepiness. Biochemical changes in the oral fluid were characterized by fluctuations between morning and evening readings. So, in the morning the level of cortisol was 7.06 [5.32; 8.25] ng/ml, corresponding to the average values. In the evening, there was a statistically significant decrease ( p <0.02) in the hormone level to 5.93 [3.73; 7.74] ng/ml. Similar fluctuations in the total antioxidant activity of the oral fluid were revealed: with an increase in the value in the morning (16. 33 [14.63; 17.55] mg/l) and a significant ( p <0.001) decrease in the evening (14.08 [12.58; 14.59] mg/l).

No significant differences were found among the students of the main group in terms of the introversion-extroversion test, the level of reactive and personal anxiety (according to the Spielberger-Khanin scale), resistance to stress, when compared with the control. A statistically significant increase in neuroticism was found ( p <0.01) with an average level of values for this test and psychotism ( p <0.03) with a level of indicators defined as "a tendency to emotional inadequacy". Emotional instability in the presence of episodes of shift work was manifested by an increase in the level of anxiety according to the personality scale of manifestations of anxiety Taylor ( p <0.01) with a tendency to high values.

Analysis of self-assessment of sleep according to tests of sleep quality and daytime sleepiness (according to the Epworth scale) did not reveal any differences from the control group. The main complaints of students were associated with impaired sleep hygiene, which corresponded to significantly higher values than in the control group ( p <0.01). In the group with shift work, the level of cortisol in the oral fluid was increased. Thus, the data recorded in the morning hours differed statistically significantly from the control group ( p <0.02) and amounted to 8.59 [7.41; 9.51] ng/ml. The daily dynamics was preserved ( p <0.005) with a regular decrease in the hormone in the evening to 6.35 [5.66; 7.60] ng/ml. The persistence of differences between morning and evening cortisol levels in the oral fluid reflects the homeostatic stability of circadian rhythm. Shift work results in a statistically significant 21% increase in hormone levels from 7:00 am to 11:00 am and a trend towards higher cortisol levels from 4:00 pm to 8:00 pm.

The fluctuations in cortisol levels described above were accompanied by opposite changes in the total antioxidant activity of the oral fluid. In the morning, its values reached 14.48 [10.94; 16.72] mg/l, which turned out to be significantly lower ( p <0.05) than in the control group and led to the destruction of the dynamics of daily fluctuations in antioxidant activity during shift work. The revealed leveling of differences between morning and evening indicators of total antioxidant activity is associated with a decrease in values in the first half of the day, while in the evening the data did not differ from the control group.

Thus, students with shift work experience, even in the absence of its periodicity, have a change in their psycho-emotional state, which is manifested in an increase in the number of respondents with increased anxiety, an increase in psychotism and neuroticism. Emotional instability was accompanied, according to self-assessment, by a statistically significant decrease in the quality of sleep hygiene. Biochemical parameters of the oral fluid significantly differed only in the morning hours and were manifested by an increase in the level of cortisol and a decrease in antioxidant activity.

Discussion

The role of personality traits in shift work of students was assessed by tests of the Eysenck questionnaire. According to the literature [14], changes in the extraversion–introversion test are due to activity in the reticular-thalamo-cortical loop and affect cortical activity, and a deviation in this test may indicate a reduced ability to tolerate lack of sleep. The data obtained in this study did not reveal differences in personality characteristics in terms of extraversion-introversion between the groups examined, which suggests their homogeneity. However, among students with shift work, there was a predominance of the level of neuroticism and psychotism, indicating an increase in emotionality and a decrease in its control. This is confirmed by the results of other studies [15]. Thus, people with shift work (oil industry workers) have a higher level of neuroticism compared to day shift workers, but this does not allow us to explain all the changes in mental health during shift work.

Increased neuroticism is characteristic of people with problems falling asleep. Longitudinal studies [16] evaluated the same individuals at the age of 15, 17, 25 and 37 years. Adolescent neuroticism did not affect the ability to predict sleep problems in adulthood. Sleep problems during adolescence and early adulthood were predictive of neuroticism in middle age. Some instability of emotions may be the result of psychological stress in the conditions of combining study and work. In experiments on modeling the workload in individuals with increased neuroticism [17], a decrease in the parameters of labor results was noted. The authors point to the consistency of the data obtained with Eysenck's theory, since neuroticism is based on the activation of the limbic system in response to environmental stressors and is realized depending on the level of activation thresholds of the sympathetic nervous system. Neuroticism has been identified as the best predictor of subjective self-reported sleep, including nighttime sleep quality and insomnia, in questionnaire-based studies [18]. Emotional instability in students with night work experience is confirmed by an increase in their anxiety (according to the Taylor scale). This scale is most suitable for identifying high anxiety as a chronic mental experience or sustained somatic tension, which manifests itself in fatigue, impatience, a feeling of inner enslavement, a tendency to experience bouts of unconscious fear and uncontrollable anxiety even for a minor reason. In persons with increased anxiety, according to a study by E.V. Verbitsky [19], electrical activity of the brain changed during sleep. Earlier studies [20] showed that anxious subjects (on the Taylor scale) were rigid in sleep habits, more lethargic in overcoming sleepiness during shift work, while anxiety did not change circadian temperature indicators during shift work.

In the present study, sleep disturbances were manifested by decreased scores on the Sleep Hygiene Quality Scale without evidence of daytime sleepiness. It should be noted that students with shift work experience showed a significant increase in cortisol levels and a decrease in saliva antioxidants in the morning. This was consistent with the data of the study [21], indicating an increase in cortisol after awakening in individuals with increased neuroticism. An increase in the hormone level was recorded 45 min after awakening and persisted for 12 h. In other studies [22], patients with high neuroticism showed a half-hour increase in salivary cortisol levels 30 min after awakening. Oxidative stress can accompany impaired emotional stability. A correlation was found between the level of neuroticism and anxiety and oxidative stress in female students [23]. Intermittent sleep disturbance may affect antioxidant status. Thus, in men during shift work, the level of antioxidant activity of blood serum decreased [24]. The data obtained are consistent with the idea of changes in emotional status as a key factor associated with sleep and circadian rhythm [25].

The results of studies on the study of psychophysiological indicators in students with episodic experience of shift work indicate a change in emotional balance, which is manifested by an increase in neuroticism, anxiety, an increase in cortisol levels and a decrease in antioxidants in saliva.

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