ABSTRACT
OBJECTIVES: This study aimed to investigate the potential reduction of academic stress related to a graded oral presentation in postgraduate dental students using coffee aromatherapy. METHODS: Healthy postgraduate dental students in a seminar class were divided into coffee (n = 32) and control (n = 26) groups. There were 3 modes of aroma distribution: personal distribution with a coffee pad attached to a lanyard, a lanyard plus a personal fan for ventilation of the aroma, and the typical method of the diffuser to spread the aroma in the ambient air. Stress markers comprised levels of salivary alpha-amylase (sAA), cortisol (sCort), and chromogranin A (sCgA). Pulse rates were also measured. RESULTS: Levels of sAA increased 176.62% ± 30.26% between pre- and postpresentation in the control group. Inhaling coffee aroma during the presentation period significantly ameliorated sAA increase at 81.02% ± 14.90% (P = .015). sCort levels tended to decrease in the coffee group, but not significantly. Surprisingly, sCgA levels increased more in the coffee group. Also, pulse rates decreased in the coffee group (-2.07 ± 2.81 bpm) and increased in the control group (6.90 ± 3.22 bpm; P = .035). Subgroup analysis did not reveal differences in salivary markers amongst the 3 aroma distribution modes. CONCLUSIONS: Coffee aroma could have an anxiolytic effect on postgraduate dental students, as evidenced by changes in sAA levels and pulse rates. Personal aroma distribution was also a useful and effective mode of aromatherapy.
ABSTRACT
The study aimed to determine how different baseline states of mind in each day (relaxed, ordinary, or stressful) affected the diurnal patterns of three commonly investigated salivary stress biomarkers: cortisol (sCort), alpha-amylase (sAA), and chromogranin A (sCgA). A total of 32 healthy volunteers collected saliva on three different mood days at six time points each day (awakening, 30 min after, 10:00, 12:00, 16:00, and 19:00 h). Pulse rates and subjective feeling of stress using a visual analog scale (VAS) were also recorded. The levels of sCort and sAA were highest on a stressful day at certain time points. The levels of sAA were lowest on a relaxing day in the afternoon. Surprisingly, sCgA levels showed an opposite pattern with the highest level seen on a relaxing day. Of note was that the majority of the participants chose a day during a meditation retreat as their relaxing day and participants practicing mindfulness manifested lower levels of sCort (p = 0.003) and sAA (p = 0.043) at 19:00 h compared with those choosing a general leisure day as their relaxing day. Different states of mind were associated with different courses of salivary stress biomarkers. sCort and sAA are the most reliable markers showing the expected trend with higher levels on a stressful day and lower levels on a relaxing day. While the current result cast doubt on the use of sCgA as a stress marker since it was the only marker that showed the opposite trend compared with those of the other two markers as well as pulse rates and VAS. Furthermore, this is the first study to demonstrate that mindfulness practice might have different effects on these biomarkers from just a general relaxed state of mind.
ABSTRACT
Salivary biomarkers have been widely used to help diagnose stress, anxiety, and/or depression. This study aimed to compare the responses of three commonly investigated salivary stress biomarkers that represent the hypothalamic-pituitary-adrenal activity (cortisol; sCort) and the sympathetic activity (alpha-amylase; sAA and chromogranin A; sCgA), using academic oral presentation as a model of stress. Twenty postgraduate dental students attended the seminar class as presenter and audience. The presenters' performances were evaluated by the instructors suggesting more stress than the audience. The saliva was collected two times: before attending class and after an academic presentation (for presenters) or during the class (for audience). The pulse rates (PR) were also recorded. The results showed that the levels of all three biomarkers, as well as PR, were significantly higher in the presenter group compared with the audience group; however, the changes were most prominent with sCort and sAA (99.56 ± 12.76% for sCort, 93.48 ± 41.29% for sAA, 16.86 ± 6.42% for sCgA, and 15.06 ± 3.41% for PR). When compared between pre-post presentation, the levels of sCgA were not different, while those of sCort and sAA were significantly increased. These results suggest more sensitive reactivity to academic stress of sCort and sAA compared with sCgA and that the response of sCgA did not necessarily follow sAA pattern even though both are claimed to reflect the sympathetic activity. More studies are needed to elucidate the roles of sCgA in stress.
