Sleep Hormone Test | Sleep & Stress Lab Test

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 test checks the morning levels of these 2 hormones. For this test, cortisol is collected from a blood draw and melatonin is collected with a urine sample.

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 sleep hormone test, visit a nearby Quest location, and get fast results.

Please note: For best results, it is recommended that you schedule an appointment for sample collection in the morning only (between the hours of 7am and 9am).

Sample type: Blood 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

For a more expanded view of your cortisol, Quest offers the Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment, which includes the same 2 hormones but measures salivary cortisol at 4 points throughout the day. The 4-point test provides a detailed curve that reveals if your "stress hormone" is rising and falling at the wrong times, causing "wired-but-tired" symptoms.

This sleep lab test measures morning levels of two key hormones involved in the sleep-wake cycle: cortisol (in blood) 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. This cortisol blood test measures the morning level of cortisol present in your blood. This test uses a single blood draw collected during that peak window (7am-9am) to provide a snapshot of your cortisol level at its highest point in the day.

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 sample collection at a Quest Diagnostics location or through Quest Mobile® where available, a convenient option for in-home sample collection*. Collection is not available in AZ, HI, or PR.

*Check your zip code here for service availability, not available in all locations. Quest Mobile is currently only available for individuals ages 18+.

For best results, it is recommended that you schedule an appointment for sample collection in the morning only (between the hours of 7am and 9am). No special preparation is required.

After you provide your specimen, it generally takes up to 9 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 — Morning Snapshot	Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment	Cortisol Stress Hormone Test
Cortisol — 4 samples
Cortisol — 1 sample
Melatonin
	$149.00	$199.00 Learn More	$79.00 Learn More

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

How it works

questhealth.com offers 150+ consumer-initiated Quest Diagnostics lab tests to empower you to have more control over your health journey. Choose from a variety of test types that best suit your needs.

In-person
In-home sample collection

1

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No doctor visit is required for purchase, but an independent healthcare provider is involved throughout the process.

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2

Register your test
& schedule an appointment

Book a visit to one of 2000+ Quest locations.

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3

Visit Quest for sample collection

Complete your test sample collection during your scheduled appointment.

4

Get fast results

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.

1

Buy a lab test
+ in-home sample collection

No doctor visit required for purchase. If in-home service is available in your area, purchase for an additional $79 fee.

Buy now

2

Register your test
& schedule an appointment

After you make a purchase, register your test and Quest Mobile will contact you to schedule an in-home sample collection appointment.

Register your test

3

In-home sample collection

A Quest Mobile phlebotomist will collect your sample and deliver it to Quest Diagnostics.

4

Get fast results

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.

Please note: Quest Mobile is currently only available for individuals ages 18+.

Why are 70 million Americans not getting enough sleep? The answer might lie in two important hormones and different factors in your everyday routine. See tips for getting more restful sleep.

FAQs

Why does my sample need to be collected between 7am and 9am?

Cortisol follows a natural daily rhythm—it peaks in the early morning and gradually declines throughout the day. This peak, which typically occurs between 7am and 9am, represents your body's baseline cortisol response and is the most clinically meaningful window for assessing whether your cortisol levels are within a normal range.

This test uses a single blood draw collected during that peak window to provide a snapshot of your cortisol level at its highest point in the day. Collecting outside this window—even by a few hours—can produce results that appear abnormal simply because cortisol levels are naturally lower later in the day, making them harder to interpret accurately. To get the most useful picture of your cortisol levels, timing your sample collection within this window is key.

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.

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.

Why is urine used to measure melatonin?

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.

How is this test different from the Cortisol & Melatonin (Sleep Hormone) Test Panel — Full-Day Assessment offering?

This Morning Snapshot measures cortisol and melatonin from samples collected at a single morning appointment. The Cortisol & Melatonin (Sleep Hormone) Test Panel — 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.

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.

Cortisol & Melatonin (Sleep Hormone) Test Panel — Morning Snapshot