Evaluation of salivary melatonin measurements for Dim Light Melatonin Onset calculations in patients with possible sleep–wake rhythm disorders

Keijzer, Henry; Smits, Marcel G.; Peeters, Twan; Looman, Caspar W.N.; Endenburg, Silvia C; Gunnewiek, Jacqueline M. T. Klein

doi:10.1016/j.cca.2011.05.014

Cited by 59 publications

(40 citation statements)

References 38 publications

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“…Moreover, at-home DLMO is used in routine clinical care in large cohorts of patients (36). This measure was available for 80% of patients in our cohort, which is the usual rate of success of such a measurement (36).…”

Section: Discussionmentioning

confidence: 99%

Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag

Larcher

Gauchez

Lablanche

et al. 2016

European Journal of Endocrinology

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Background: Sleep behavior is changing toward shorter sleep duration and a later chronotype. It results in a sleep debt that is acquitted on work-free days, inducing a small but recurrent sleep misalignment each week, referred to as "social jetlag". These sleep habits could affect health through misalignment with circadian rhythms. Objectives: The primary objective is to address the impact of sleep behavior on glycemic control, assessed by HbA1c, in patients with type 1 diabetes, independently of other lifestyle or sleep-related factors. The secondary objective is to address whether circadian phase affects glycemic control. Design: In total, 80 adult patients with type 1 diabetes (46% female) were included in a clinical cohort study. Methods: Sleep behavior was addressed objectively by a 7-day actimetry, lifestyle by questionnaires, sleep breathing disorders by nocturnal oximetry and circadian phase by dim light melatonin onset (DLMO). Results: Univariate analyses showed that chronotype (r = 0.23, P = 0.042) and social jetlag (r = 0.30, P = 0.008) were significantly associated with HbA1c. In multivariable analysis, social jetlag was the only sleep habit independently associated with HbA1c (β = 0.012 (0.006; 0.017), P < 0.001). HbA1c was lower in patients with a social jetlag below versus above the median (7.7% (7.1-8.7) and 8.7% (7.6-9.8), P = 0.011). DLMO was not associated with HbA1c. However, the later the DLMO, the worse the sleep efficiency (r = −0.41, P < 0.001) and fragmentation index (r = 0.35, P = 0.005). Conclusions: Social jetlag, a small but recurrent circadian misalignment, is associated with worse glycemic control in type 1 diabetes, whereas circadian phase is not. Further intervention studies should address the potential improvement of glycemic control by correcting social jetlag.

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Section: Discussionmentioning

confidence: 99%

Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag

Larcher

Gauchez

Lablanche

et al. 2016

European Journal of Endocrinology

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“…This is a very similar methodology to that described by Keijzer et al 57 in which five evening collections were effective in the majority of cases when evaluating dim-light melatonin onset (DLMO) timing for patients with circadian rhythm disorders. A minimum of 2 ml of saliva was obtained by asking the child to spit into a tube or by placing a saliva sponge in the buccal cavity (cheek pouch) of the child's mouth (the space between the gums and the inner cheek).…”

Section: Salivary Melatonin Assaymentioning

confidence: 99%

The use of MElatonin in children with Neurodevelopmental Disorders and impaired Sleep: a randomised, double-blind, placebo-controlled, parallel study (MENDS).

Appleton

Jones²,

Gamble³

et al. 2012

Health Technol Assess

117

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“…Saliva for melatonin assay is often self-collected and stored at home with reliable results (Keijzer et al, 2011). Measurement interference can arise from bleeding gums (Pullman et al, 2012), toothpaste (Figueiro & Rea, 2010), caffeine, tobacco and alcohol (Hartter et al, 2006;Zhou et al, 2009) leading to erratic values.…”

Section: Introductionmentioning

confidence: 99%

Melatonin rhythms in renal transplant recipients with sleep–wake disturbances

Burkhalter

Geest

Wirz‐Justice

et al. 2016

Chronobiology International

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We assessed salivary melatonin levels in renal transplant (RTx) recipients who participated in a randomised, multicentre wait-list controlled trial on the effect of bright light therapy on their sleep and circadian rhythms. A large proportion of RTx recipients in our cohort had unexpectedly low melatonin values, which precluded calculation of the dim-light melatonin onset (DLMO) as a circadian marker. Thus, the aim of this post hoc analysis was to describe the melatonin profile of home-dwelling RTx recipients diagnosed with sleep-wake disturbances (SWDs). The participants were characterised by means of sleep questionnaires, validated psychometric instruments [Pittsburgh sleep quality Index (PSQI), Epworth sleepiness scale (ESS), Morningness-Eveningness Questionnaire (MEQ) and Depression, Anxiety and Stress Scale (DASS)] in addition to melatonin assay in saliva. Data were analysed with descriptive statistics and group comparisons made with appropriate post hoc tests. RTx recipients [n = 29 (aged 54.83 ± 13.73, transplanted 10.62 ± 6.84 years ago)] were retrospectively grouped into two groups: RTx recipients whose dim light melatonin onset (DLMO) could be calculated (n = 11) and those whose DLMO could not be calculated (n = 18). RTx recipients having a measurable DLMO had a number of differences from those without DLMO: they were younger [46.4 ± 14.9

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Evaluation of salivary melatonin measurements for Dim Light Melatonin Onset calculations in patients with possible sleep–wake rhythm disorders

Cited by 59 publications

References 38 publications

Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag

Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag

The use of MElatonin in children with Neurodevelopmental Disorders and impaired Sleep: a randomised, double-blind, placebo-controlled, parallel study (MENDS).

Melatonin rhythms in renal transplant recipients with sleep–wake disturbances

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