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Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment

$199.00

+ $6.00 Physician Service Fee

HSA/FSA Accepted

Measure cortisol and melatonin — 2 key hormones involved in keeping you awake and helping you sleep — using a urine sample and 4 saliva samples across a full day. Cortisol naturally rises in the morning and falls through the day as melatonin takes over at night. Capturing cortisol at 4 points alongside a urine melatonin measurement provides a more complete picture of how this balance is working and where it may not be. Results may help you and your healthcare provider understand potential hormonal imbalances contributing to poor sleep, insomnia, or disrupted sleep patterns. Read more

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Cortisol and melatonin are 2 key hormones involved in regulating your circadian rhythm — your body’s natural sleep-wake cycle. Cortisol is produced by the adrenal glands and naturally rises in the morning to promote wakefulness, then falls throughout the day. As cortisol drops in the evening, the pineal gland begins releasing melatonin in response to darkness, preparing your body for sleep. When this pattern is working as it should, you feel alert during the day and ready to sleep at night.

This sleep hormone test measures cortisol at 4 points across the day using saliva samples you collect at home, alongside a urine sample to measure melatonin. Together, these 2 measurements capture how your sleep-wake hormones are shifting throughout the day — not just at a single moment. When the pattern is disrupted — for example, if cortisol stays high into the evening or melatonin levels are lower than they should be — it may help explain symptoms such as difficulty falling asleep, frequent waking, or feeling unrefreshed in the morning.

Results may help you and your healthcare provider identify hormonal factors contributing to poor sleep quality or insomnia, or monitor a known sleep or hormone condition.

No doctor’s visit needed. Buy this full-day sleep hormone test and visit a nearby Quest location.

Sample type: Saliva and Urine
Test type: In Person
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This test may be right for you if any of the following are true:

You have difficulty falling asleep, staying asleep, or regularly wake up feeling unrefreshed
You are not getting the recommended amount of sleep each night and want to understand whether your hormone levels may be a contributing factor
You experience high stress or anxiety that you believe may be affecting your sleep
You work night shifts, irregular hours, or frequently travel across time zones and have noticed changes to your sleep patterns
You are in perimenopause or menopause transition and are experiencing sleep disturbances
You currently take melatonin supplements and want to understand your baseline hormone levels
You have been previously diagnosed with a sleep condition and want to monitor your cortisol and melatonin levels
You are experiencing any of the signs and symptoms listed below

Quest also offers the Cortisol & Melatonin (Sleep Hormone) Test Panel — Morning Snapshot, which measures the same 2 hormones but in a single blood and urine morning test which can help gain insight into your sleep-wake hormone balance.

This sleep lab test measures levels of 2 key hormones involved in the sleep-wake cycle: cortisol (in saliva at 4 points during the day) and melatonin (in urine). These hormones typically follow an inverse (opposite) circadian (recurring natural biological 24-hour cycle) pattern—cortisol levels are usually high in the morning to promote wakefulness, while melatonin levels are low after peaking during the night to support sleep.

The adrenal glands above the kidneys produce cortisol. Cortisol is the body’s main stress hormone and fluctuates throughout the day. It aids in regulating inflammation, blood pressure, blood sugar, sleep cycles, and metabolism — especially in stressful situations. Normally the body will regulate cortisol levels to deal with stress and pressure, but sometimes our bodies remain in a stressed state for too long. Too much (hypercortisolism) or too little (hypocortisolism) cortisol can result in the body’s inability to complete its normal functions and may lead to health problems such as anxiety, depression, headaches, memory issues, digestion problems, trouble sleeping, weight gain, and heart disease.

Saliva is used to measure cortisol in this test because it more accurately reflects the amount of cortisol that is actively available for your body to use, rather than the total amount present in your blood. This makes it particularly useful when taking multiple measurements over the course of the day to track how your adrenal glands are responding in real time. When functioning optimally, cortisol naturally rises and falls throughout the day in a predictable pattern; collecting samples at 4 points — morning, midday, late afternoon, and evening — allows this test to map your cortisol pattern across the day. This can help identify whether levels are consistently low, consistently high, or shifting at the wrong times, which a single blood draw would not reliably detect if your body is not following the optimal pattern. It is important to note that certain substances such as tobacco, licorice, and topical steroid creams may affect salivary cortisol results.

The pineal gland, located in the brain, is a small gland in your endocrine system that produces the hormone melatonin. Your pineal gland makes and releases the highest levels of melatonin during the night. Very small amounts are produced during the day. This is why melatonin is often referred to as the “sleep” hormone. Too much (hypermelatoninemia) and too little (hypomelatoninemia) melatonin can result in the body’s inability to complete its normal functions and may lead to health problems such as trouble sleeping, dizziness, hypotonia (muscle weakness), desire to sleep during the day, low body temperature, high blood pressure, and type 2 diabetes.

When your body produces melatonin, your level typically peaks in the middle of the night and falls again before morning. This rise and fall is a key part of your body’s natural sleep-wake cycle, and disruptions to it can affect both your ability to fall asleep and the quality of sleep you get.

Urine is used to measure melatonin because it captures a metabolite that reflects how much melatonin your body has produced and processed over a period of time. This provides a more stable and representative measure of your overall melatonin output than a single blood or saliva reading at one point in time.

Signs and symptoms that may be associated with sleep-wake hormone imbalance include:

Possible symptoms associated with low cortisol:

Persistent fatigue or muscle weakness
Dizziness or low blood pressure
Unexplained weight loss or reduced appetite
Salt cravings
Nausea or digestive discomfort
Skin darkening (especially in skin folds or scars)

Possible symptoms associated with high cortisol:

Weight or body composition changes (for example weight gain around the abdomen or face)
Blood pressure, blood sugar, or energy level changes
Decreased libido
Sleep difficulties
Easy bruising or skin changes
Mood changes

Possible symptoms associated with low melatonin:

High blood pressure
Obesity
Metabolic syndrome
Insulin resistance
Various sleep disorders
Difficulty falling asleep or staying asleep
Waking frequently during the night
Feeling unrefreshed in the morning
Daytime sleepiness or fatigue

Possible symptoms associated with high melatonin (rare):

Trouble sleeping (usually involving sleeping during the daytime)
Dizziness
Muscle weakness
Low body temperature

Purchaser: You must be 18 years of age or older to purchase a test on questhealth.com.

Patient: This test can be performed on patients between 18 and 100 years old.

Sample collection: This test requires 2 visits to a Quest Diagnostics location. Collection is not available in AZ, HI, or PR.

You’ll need to book 2 appointments: the first to pick up your saliva sample containers, and a second to return your saliva samples and provide your urine sample. Certain supplements and medications can interfere with your test results. If you are concerned about any of your supplements or medications impacting your results, talk to your healthcare provider before your sample is collected to see if you should stop taking them and for how long. Consider avoiding smoking and licorice as both are known to contain an ingredient that may elevate salivary cortisol.

After you provide your specimen, it generally takes up to 10 business days to process and release your test results. However, processing times may vary. Your test results will be available in a clear and easy-to-read report. If you have or create a MyQuest® account, you may be able to review your new results there with your other Quest results. Independent healthcare providers are available to discuss questions or concerns you may have regarding your results.

Compare products

Test For	Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment	Cortisol & Melatonin (Sleep Hormone) Test Panel — Morning Snapshot	Cortisol Stress Hormone Test
Cortisol — 4 samples
Cortisol — 1 sample
Melatonin
	$199.00	$149.00 Learn More	$67.15 ~~$79.00~~ Learn More

Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment	Cortisol & Melatonin (Sleep Hormone) Test Panel — Morning Snapshot	Cortisol Stress Hormone Test
Cortisol — 4 samples
Cortisol — 1 sample
Melatonin
$199.00	$149.00 Learn More	$67.15 ~~$79.00~~ Learn More

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Access results online as soon as they’re available. You will be emailed when they are ready. Discuss your results with an independent healthcare provider at no extra cost. Treatment options may be available.

Having too much or too little cortisol can affect the critical bodily functions it helps regulate. That’s why it’s crucial to understand how to check cortisol levels.

FAQs

How are cortisol and melatonin related?

These hormones typically follow an inverse (opposite) circadian (recurring natural biological 24-hour cycle) pattern. Cortisol and melatonin have an opposite relationship and work together to regulate sleep and wake cycles. Cortisol levels are typically highest in the morning, when melatonin levels are low, and tend to decrease throughout the day. At night, cortisol levels continue to decrease, while levels of melatonin start to rise in response to darkness, preparing the body to sleep.

How is this test different from the Cortisol & Melatonin (Sleep Hormone) Test Panel — Morning Snapshot offering?

The Morning Snapshot measures cortisol and melatonin from samples collected at a single morning appointment. This Full-Day Assessment adds 4 salivary cortisol measurements collected at home across the day, alongside a urine sample for melatonin. This captures how your sleep-wake hormones are shifting throughout the day rather than at one moment, which may help identify disruptions — such as cortisol remaining elevated into the evening — that a single morning reading would not detect.

Do I need to provide my saliva sample at the appointment?

No. Saliva samples are collected at home, not at the Patient Service Center (PSC). At your first appointment, you’ll pick up your saliva sample containers (salivettes) and instructions. You’ll then collect your sample at home, following the instructions that will be provided with your kit. You will return your samples at your second appointment. Click here for saliva sample collection instructions.

When do I collect my four saliva samples?

Saliva samples are collected at four points throughout the day to capture your cortisol pattern from morning to evening. The recommended collection times are:

Morning — within 30 minutes of waking
Midday — between 11:00 AM and 1:00 PM
Late afternoon — between 4:00 PM and 6:00 PM
Evening — before going to bed

Following these time points as closely as possible will give you the most accurate picture of your cortisol levels throughout the day. Specific instructions will be provided with your saliva collection kit and can be found here.

When do I provide my urine sample?

Your urine sample for melatonin will be collected at your second appointment.

Why is urine used to measure melatonin?

Why is saliva used to measure cortisol?

Saliva measures the portion of cortisol that is actively available for your body to use, rather than the total amount present in your blood. This makes it a useful way to assess how your adrenal glands are responding in real time. Salivary cortisol collection also allows samples to be taken at multiple points throughout the day at home, which is not practical with blood draws.

Can I eat or drink before collecting my saliva samples?

You should avoid eating, drinking anything other than water, brushing your teeth, or using mouthwash for at least 30 minutes before each saliva collection. Certain foods, drinks, and oral hygiene products can affect cortisol levels in saliva and may impact your results. Certain supplements and medications can interfere with your test results. If you are concerned about any of your supplements or medications impacting your results, talk to your healthcare provider before your sample is collected to see if you should stop taking them and for how long. Consider avoiding smoking and licorice as both are known to contain an ingredient that may elevate salivary cortisol. Full preparation instructions will be provided with your collection kit and you can also find them here.

Are sleep disorders common?

The recommended amount of sleep per night for adults is seven hours. More than 50 million people in the United States have been diagnosed with a sleep disorder and closer to 100 million people report that they do not get an adequate amount of sleep daily. When either, or both, of these hormone levels are not working as they are supposed to, the body’s internal clock can get messed up with one of over 80 different sleep disorders, affecting overall health and leaving a person with low levels of energy. If you are experiencing any of the signs and symptoms listed below, this sleep hormone test may be for you.

Is this test relevant for shift workers or people with irregular sleep schedules?

Yes. People who work night shifts, rotating shifts, or irregular hours are more likely to experience disruptions to their natural cortisol and melatonin patterns because their sleep and wake times don’t align with the body’s natural light-dark cycle. This can affect how well cortisol and melatonin rise and fall at the right times. If you are experiencing sleep difficulties related to your work schedule or lifestyle, this test may help identify whether your sleep-wake hormones are contributing to those symptoms.

Can this test diagnose a sleep disorder?

No, a single test cannot diagnose a sleep disorder. This test measures cortisol and melatonin levels but does not diagnose a sleep disorder on its own. Abnormal results may indicate the need for additional evaluation or follow-up testing with a healthcare provider. Included with your purchase, you have the ability to discuss your results with an independent healthcare provider at no extra cost.

Can this test help if I am already taking melatonin supplements?

If you are currently taking melatonin supplements, discuss this with your healthcare provider before purchasing this test, as supplementation can affect your results. This test measures your body’s natural melatonin production, and taking supplements close to your sample collection may make it difficult to interpret whether any abnormal results reflect your body’s own hormone output or the supplement. If you want to understand your baseline melatonin levels, your provider may recommend pausing supplementation before testing.

Can this test be taken by both men and women?

Yes. Cortisol and melatonin are important hormones for both men and women, and sleep-wake disruption can affect anyone.

For women, this test may be particularly relevant if you are experiencing sleep disturbances related to hormonal changes, such as those that occur during perimenopause or menopause. Melatonin production also naturally declines with age, which can contribute to changes in sleep quality over time.

For men, this test may be relevant if you are experiencing persistent sleep difficulties, fatigue, or symptoms that suggest your stress and sleep hormones may be out of balance. Cortisol dysregulation in particular can affect sleep quality in men experiencing high levels of chronic stress.

Can I use my FSA or HSA funds to purchase tests on questhealth.com?

You may be able to use your FSA or HSA funds to purchase lab tests at questhealth.com. Please review your FSA/HSA plan or check with a tax professional to confirm specific requirements for individual eligibility.

Are tests purchased from questhealth.com covered by my health insurance?

Tests purchased on questhealth.com are intended for individuals paying directly—we do not bill insurance, and purchases cannot be submitted for insurance reimbursement.

If your doctor ordered a lab test for you and you are looking to book an appointment for sample collection, you can schedule an appointment here https://appointment.questdiagnostics.com/as-home.

For other questions related to a lab test your doctor ordered for you, including billing and results, you can visit the main Quest Diagnostics site here https://www.questdiagnostics.com.

Our references

Center for Disease Control. About Sleep. Accessed March 12, 2025. https://www.cdc.gov/sleep/about/index.html
Quest Diagnostics. Cortisol, A.M. Accessed August 10, 2023. https://testdirectory.questdiagnostics.com/test/test-detail/4212/cortisol-am?p=r&q=4212&cc=PHP
WebMD. What is Cortisol?. Accessed August 10, 2023. https://www.webmd.com/a-to-z-guides/what-is-cortisol
Cleveland Clinic. Cortisol. Accessed August 10, 2023. https://my.clevelandclinic.org/health/articles/22187-cortisol
Cleveland Clinic. Melatonin. Accessed March 12, 2025. https://my.clevelandclinic.org/health/articles/23411-melatonin
Cleveland Clinic. Sleep Disorders. Accessed March 12, 2025. https://my.clevelandclinic.org/health/diseases/11429-sleep-disorders
St. Hilaire, M.A., Lockley, S.W. (2022). Measuring Urinary 6-Sulphatoxymelatonin in Humans. In: Jockers, R., Cecon, E. (eds) Melatonin. Methods in Molecular Biology, vol 2550. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-2593-4_4

Tests purchased on questhealth.com are only for individuals who intend to pay directly for testing and do not want to submit a claim for reimbursement under their health insurance.