In humans, the end product of the HPA axis is cortisol, a steroid hormone that follows a diurnal rhythm — increasing early in the morning, peaking approximately 30 minutes after waking, and declining throughout the day, reaching
near - zero levels at night.14 This diurnal pattern is not present at birth but
begins to
emerge around 3 months of age15, 16 and is fully entrained to daylight cycles by age 2 years.17 Children experiencing social deprivation or maltreatment show departures from this typical profile of diurnal HPA activity, suggestive of chronic stress.