[41-43] Our results indicate that anticipation also can have a more prevailing effect. An alternative explanation would be viewing the BP increase as a consequence of physical activity associated SP600125 price with travel preparations (eg, packing). However, this seems unlikely considering the limited physical demands associated as well as the morning and evening BP assessment. The continued elevation of diastolic BP suggests increased cardiovascular arousal due to coping with the novel surroundings as found in experimental research.[19] Evidence for increased cardiovascular activity in association with travel and a CoR previously has been found in a study on the prevalence of myocardial infarction

during vacation, which was significantly more common

during the first 2 days.[44] Total average BP increases were 2 to 3 mmHg with no indication of morning–evening differences or heightened responses in certain subgroups. Thus, considering the small magnitude and the transient nature of the BP responses, these cannot be regarded as clinically significant. The return of BP to baseline on day 5 of the stay illustrates the transient nature of the CoR response, but also may be a preliminary reaction to spa-treatment, which tends to lower BP.[45] On the first night at the health resort individuals reported poorer sleep compared to baseline. This finding corroborates the “first-night effect” in sleep research.[12-14] The present result indicates that this phenomenon is not limited to the sleep laboratory, but may be a common reaction to sleeping in any novel environment. However, DNA Damage inhibitor verification with objective sleep measures would be necessary. Morning mood did not respond to the CoR, contrary to our expectation. Several explanations can be put forth to account for this lack of response. First,

mood may not be a measure sensitive to the psychological demands associated with a CoR. Possibly, other variables such as anxiety or perceived tension would have been more adequate. Second, a potential deterioration of mood related to the anticipation of and/or exposure to the novel environment may have been masked by positive expectations, known as the “rosy view” phenomenon, and the curiosity induced by novelty.[46, 47] At this point, a more detailed psychological mapping of the responses to a CoR seems warranted the for future studies. The improvement of mood on the fifth day after CoR is presumably related to a respite from work and the corresponding psychological recovery.[40, 48, 49] The responses to the CoR were not associated with demographic, medical, or travel-related variables except for the retirement status, those retired showing a slightly larger diastolic BP response to the CoR. Whether individuals previously had visited the resort or not also did not affect the responses possibly due to the minimum of 2 years between the current and past visit.