Background: The cortisol awakening response (CAR) has been used as a biomarker of stress response in a
multitude of psychological investigations. While a myriad of biochemical responses have been proposed to monitor
responses to exercise training, the use of CAR within the exercise and sports sciences is currently limited and is a
potentially underutilized variable. Therefore, the purpose of this review was to collate studies that incorporate both
exercise and CAR, in an effort to better understand (a) whether CAR is a useful marker for monitoring exercise stress
and (b) how CAR may be most appropriately used in future research.
Methods: A systematic review of the literature was conducted, following PRISMA guidelines. Searches were
conducted using PubMed, SportDISCUS, Scopus, and PsychInfo databases, using search terms related toCAR and
exercise and physical activity.