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
{"title":"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。","authors":"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","doi":"10.1111/jpi.12994","DOIUrl":null,"url":null,"abstract":"<p>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 <i>in-laboratory</i> 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.</p>","PeriodicalId":198,"journal":{"name":"Journal of Pineal Research","volume":"76 5","pages":""},"PeriodicalIF":8.3000,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpi.12994","citationCount":"0","resultStr":"{\"title\":\"A Protocol to Determine Circadian Phase by At-Home Salivary Dim Light Melatonin Onset Assessment\",\"authors\":\"Jade M. Murray, Julia E. 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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.
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.