通过家庭唾液暗光褪黑激素起始评估确定昼夜节律阶段的方案。

IF 8.3 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Journal of Pineal Research Pub Date : 2024-08-19 DOI:10.1111/jpi.12994
Jade M. Murray, Julia E. Stone, Sabra M. Abbott, Bjorn Bjorvatn, Helen J. Burgess, Christian Cajochen, Jip J. Dekker, Jeanne F. Duffy, Lawrence J. Epstein, Corrado Garbazza, John Harsh, Elizabeth B. Klerman, Jacqueline M. Lane, Steven W. Lockley, Milena K. Pavlova, Stuart F. Quan, Kathryn J. Reid, Frank A. J. L. Scheer, Tracey L. Sletten, Kenneth P. Wright Jr., Phyllis C. Zee, Andrew J. K. Phillips, Charles A. Czeisler, Shantha M. W. Rajaratnam, International Association of Circadian Health Clinics
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引用次数: 0

摘要

人们日益认识到,内部昼夜节律相位评估是诊断、监测和治疗昼夜节律睡眠-觉醒障碍以及研究其他疾病的昼夜节律时间的重要临床工具。在常规临床实践中,实验室内昼夜节律相位评估的广泛应用一直受到限制,这很可能是因为昼夜节律相位评估并非正式诊断命名所要求的,而且通常也不在保险范围内。对唾液暗光褪黑激素起始期(DLMO,一种有效的昼夜节律相位标志物)进行居家评估是一种日益被接受的昼夜节律相位评估方法。这种方法有助于满足日益增长的评估需求,而且具有成本低、更方便患者的优点。我们回顾了描述居家唾液 DLMO 评估方法的文献,并确定了成功实施的重要因素。在此,我们提供了进行居家唾液 DLMO 评估的具体方案建议,以促进临床和研究目的的标准化方法。关键因素包括对照明、采样率和时间的控制,以及对患者依从性的测量。我们纳入了优化算法的实施结果,以确定睡眠-觉醒延迟期障碍患者最有效的采样数量和时间。我们还对检测方法和解释提出了建议。提供每个因素的明确标准以及方案实施的详细说明,将有助于更广泛地采用居家昼夜节律相位评估作为标准化的临床诊断、监测和治疗工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A Protocol to Determine Circadian Phase by At-Home Salivary Dim Light Melatonin Onset Assessment

Internal circadian phase assessment is increasingly acknowledged as a critical clinical tool for the diagnosis, monitoring, and treatment of circadian rhythm sleep−wake disorders and for investigating circadian timing in other medical disorders. The widespread use of in-laboratory circadian phase assessments in routine practice has been limited, most likely because circadian phase assessment is not required by formal diagnostic nosologies, and is not generally covered by insurance. At-home assessment of salivary dim light melatonin onset (DLMO, a validated circadian phase marker) is an increasingly accepted approach to assess circadian phase. This approach may help meet the increased demand for assessments and has the advantages of lower cost and greater patient convenience. We reviewed the literature describing at-home salivary DLMO assessment methods and identified factors deemed to be important to successful implementation. Here, we provide specific protocol recommendations for conducting at-home salivary DLMO assessments to facilitate a standardized approach for clinical and research purposes. Key factors include control of lighting, sampling rate, and timing, and measures of patient compliance. We include findings from implementation of an optimization algorithm to determine the most efficient number and timing of samples in patients with Delayed Sleep−Wake Phase Disorder. We also provide recommendations for assay methods and interpretation. Providing definitive criteria for each factor, along with detailed instructions for protocol implementation, will enable more widespread adoption of at-home circadian phase assessments as a standardized clinical diagnostic, monitoring, and treatment tool.

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来源期刊
Journal of Pineal Research
Journal of Pineal Research 医学-内分泌学与代谢
CiteScore
17.70
自引率
4.90%
发文量
66
审稿时长
1 months
期刊介绍: The Journal of Pineal Research welcomes original scientific research on the pineal gland and melatonin in vertebrates, as well as the biological functions of melatonin in non-vertebrates, plants, and microorganisms. Criteria for publication include scientific importance, novelty, timeliness, and clarity of presentation. The journal considers experimental data that challenge current thinking and welcomes case reports contributing to understanding the pineal gland and melatonin research. Its aim is to serve researchers in all disciplines related to the pineal gland and melatonin.
期刊最新文献
Cover image RETRACTION: Effects of Melatonin on Fatty Liver Disease: The Role of NR4A1/DNA-Pkcs/P53 Pathway, Mitochondrial Fission, and Mitophagy From Seasonality to Species Conservation: Chronobiological Research on European Hamsters in Strasbourg, France Melatonin Inhibits ET-1 Production to Break Crosstalk Between Prostate Cancer and Bone Cells: Implication for Osteoblastic Bone Metastasis Treatment Issue Information
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