Frida Rångtell[/caption]
Frida Rångtell PhD Student
Department of Neuroscience, Division of Functional Pharmacology
Uppsala University, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies have demonstrated that evening use of electronic devices emitting blue light, e.g. tablet computers, increases time to fall asleep, reduces the quality of slow-wave sleep (a sleep stage that has for instance been shown to boost memory consolidation and immune functions), and decreases the time in rapid eye movement sleep (which has been proposed to play a role in emotional regulation and consolidation of emotional memories). One explanation could be the blue light-mediated suppression of the sleep-promoting hormone melatonin. Blue LED Warehouse or bedroom lights have a much lower effect on this because they are not shining straight into the viewer's eyes, like phone LEDs.
In the current experiment however, after 6.5 hours of constant bright light exposure during the day, there were no effects on sleep or melatonin levels after reading a traditional book versus the same book on a self-luminous tablet for two hours before bedtime. Even though the light from the self-luminous tablet was enriched in blue light. Our null findings may at first glance appear surprising, especially in light of previous epidemiological findings linking the use of electronic devices before bedtime with sleep disturbances.
One plausible explanation for these discrepant results across experiments, in our view, is that bright light exposure during daytime – similar to that employed in the present study (~570 lux over 6.5 hours prior to evening light stimulation) – has previously been shown to attenuate the suppressive properties of evening light exposure on melatonin levels.
Our results could therefore suggest that light exposure during the day, e.g. by means of outdoor activities or light interventions in offices, may help combat sleep disturbances associated with evening blue light stimulation. Finally, it must be borne in mind that reading is generally considered to be a cognitively demanding task. Thus, it could be speculated that evening reading may contribute to greater sleep pressure, which may have hampered our ability to detect differences in sleep between the tablet reading and physical book reading conditions. A recent study involving young children has for instance demonstrated that reading at bedtime is associated with improved sleep, as indicated by longer total nocturnal sleep duration.
Dr. Kunisaki[/caption]
Ken Kunisaki, MD, MS
Associate Professor of Medicine
Minneapolis Veterans Affairs Health Care System and University of Minnesota and
[caption id="attachment_26803" align="alignleft" width="98"]
Dr. Prichard[/caption]
Roxanne Prichard, PhD
Associate Professor of Psychology and Neuroscience
University of St. Thomas
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: CPAP devices, or continuous positive airway pressure devices, are used to treat obstructive sleep apnea, a common condition that causes people to intermittently stop breathing during their sleep. This leads to poor sleep quality and often results in symptoms like excessive sleepiness in the daytime. In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription. We were aware of online advertisements for secondhand, used CPAP machines, but we have not seen publications that have analyzed this practice.
Once a week, our research team monitored online advertisements for secondhand CPAP devices on Craigslist.org in 18 U.S. cities and areas over a one-month period. During that time, we found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only 5 of the advertisements mentioned anything about the legal requirements of a prescription and 61 percent of the devices included a used mask without information about its age or how it was cleaned.
CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory. Our study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners.
The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device.
Dr. Jim Burch[/caption]
Jim Burch, MS, PhD
Associate Professor
Dept. of Epidemiology & Biostatistics
Cancer Prevention & Control Program
Arnold School of Public Health
University of South Carolina, Columbia, SC and
Health Science Specialist
WJB Dorn Department of Veterans Affairs Medical Center
Columbia, SC
MedicalResearch.com: What is the background for this study?
Response: Over 21 million Veterans live in the U.S., and nearly 9 million of them receive healthcare through the Veterans Health Administration, which is the largest integrated healthcare system in the U.S. The military population is particularly vulnerable to sleep disturbances due to their work schedules, living conditions, and other physical and psychological factors that accompany their jobs. However, previous studies have not comprehensively described the scope and characteristics of sleep disorders among Veterans. Sleep is considered a physiological necessity. Inadequate sleep has been associated with a wide range of adverse health outcomes, including an increased risk of chronic diseases such as heart disease and cancer, psychiatric disorders, reduced quality of life, and increased mortality.
Dr. Azizi Seixas[/caption]
Azizi Seixas, Ph.D.
Post-Doc Fellow
Department of Population Health
Center for Healthful Behavior Change
NYU School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Compared with whites, blacks are disproportionately affected by strokes. The overwhelming prevalence of obesity among blacks compared to whites has been suggested as a possible explanation for the disproportionate rates of strokes among blacks compared to whites. Recent findings linking insufficient sleep and stroke as well as the disproportionate burden of insufficient sleep among blacks compared to whites might provide a unique mechanism explaining why blacks have higher rates of stroke. However, it is unclear whether insufficient sleep and obesity contributes to the higher rates of stroke among blacks compared to whites.
To test our hypothesis, we utilized data from the National Health Interview Survey from 2004-2013 with a sample size of 288,888 individuals from the United States. Using Bayesian Belief Network (BBN) analysis, a form of machine learning analysis, we assessed the mediating effects of BMI on the relationship between short sleep duration (≤6 hrs. total sleep duration), long sleep duration (≥9 hrs. total sleep duration), and stroke, and whether race/ethnicity differences in obesity moderated these relationships.
Dr. Azizi Seixas[/caption]
Mr. Lloyd Gyamfi and
Azizi Seixas, Ph.D.
Post-Doc Fellow
Department of Population Health
Center for Healthful Behavior Change
NYU School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: An association exists between unhealthy sleep duration (short:≤6 hrs. or long sleep: ≥ 9hrs.) and cancer. The specific link between cancer and diabetes is unknown. Evidence suggests that cancer and diabetes may share common risk factors such as age, gender, race, being overweight an alcohol use. Based on the data extracted from the National Health Interview Survey (NHIS) dataset (2004-2013) with a sample size of 283,086, it was identified that individuals who had a history of cancer and who reported long sleep duration did not have increased risk of diabetes diagnosis.
Dr. Femke Rutters[/caption]
Dr. Femke Rutters
Department of Epidemiology and Biostatistics
Vrije Universiteit Medical Centre
Amsterdam, The Netherlands;
EMGO+ Institute for Care Research
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology.
Dr. Mako Nagayoshi[/caption]
Mako Nagayoshi, Ph.D, Assistant Professor
Department of Community Medicine,
Nagasaki University Graduate School of Biomedical Science
Nagasaki Japan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sleep apnea is a common in the US adult population; approximately 13% of men and 6% of women have moderate to severe sleep apnea. Short sleep duration also is highly prevalent in the population. Numerous biological pathways linking sleep disturbances to atherosclerosis have been identified, such as insulin resistance, inflammation, hypertension, and endothelial dysfunction. Yet, the association of sleep apnea and sleep duration with peripheral artery disease (PAD) is not well characterized.
This study provides some of first evidence that there is an association between sleep apnea and prevalent and incident PAD, with evidence for stronger associations with objectively measured sleep apnea and cross sectional PAD in blacks. In addition, short and long sleep duration were associated with PAD. These results identify sleep disturbances as a potential risk factor for PAD.
Dr. Valerie Newsome[/caption]
Valerie Newsome, PhD, Postdoctoral fellow
Department of Population Health, Division of Health and Behavior
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Although sleep duration has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration. We examined data for 416,152 adult participants living in the United States between 2000-2013 who responded to the National Health Interview Survey (NHIS); associations were explored between healthy sleep duration (7-8hrs.), references to unhealthy sleep duration (8 hrs.) and place of birth.
After adjusting for socio-demographic factors, health risks, and physician-diagnosed medical conditions, multivariate logistic regression revealed that respondents born in the Indian subcontinent were more likely to report healthy sleep duration, compared with US-born respondents (OR=1.86, 95% CI: 1.57-2.20, p < 0.001), while individuals born on the continent of Africa were least likely to report healthy sleep duration (OR= 0. 86, 95% CI: 0.73-1.02, p< 0.001). We also noted a trend suggesting that the longer immigrants reside in the U.S., the greater their likelihood to experience unhealthy sleep.
Dr. Kelly Glazer Baron[/caption]
Kelly Glazer Baron, PhD, MPH, C. B.S.M.
Diplomate, Academy of Cognitive Therapy
Northwestern University
Feinberg School of Medicine
Chicago, IL 60611
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In contrast to several previous studies, being a late sleeper was not associated with higher BMI (good news for late sleepers!!) but it was associated with less healthy behaviors, more fast food, fewer vegetables, lower dairy. It may be possible that these late sleepers who are able to get enough sleep can compensate for their poor diet by controlling overall calories or it could possibly lead to weight gain over time if their habits continue over time.
Dr. Anna Alkozei[/caption]
Anna Alkozei, Ph.D.
Postdoctoral Research Fellow
SCAN Lab, Psychiatry Department
University of Arizona
Tucson, AZ 85724-5002
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Alkozei: We know that exposure to blue wavelength light, which is similar to the kind of light that we get on a bright sunny day, can improve attention and alertness during the day as well as at night. We wanted to extend previous findings by investigating whether blue light exposure can affect cognitive functioning after the blue light exposure period had already ended. We found that thirty minutes of exposure to blue wavelength light during the day, in comparison to an amber light exposure led to subsequently faster reaction times on a cognitive task forty minutes after the light exposure had already ended. Participants who were exposed to blue light also showed more efficient responding, which means they answered more items correctly per second, than individuals who were exposed to amber placebo light. Finally, we also found that individuals who were exposed to blue light showed greater activation within the prefrontal cortex when performing the task, an area necessary for optimal cognitive performance, than individuals who were exposed to amber light.
Anna Therese Lehnich[/caption]
Anna-Therese Lehnich
Zentrum für Klinische Epidemiologie (ZKE)
c/o Institut für Medizinische Informatik
Biometrie undEpidemiologie (IMIBE)
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sleep disturbances and their consequences are often underestimated but they are of high importance with respect to public health. We were interested in the question whether drugs labeled as sleep disturbing in the summary of product characteristics actually lead to more sleep disorders like difficulties falling asleep, difficulties maintaining sleep, and early morning arousal. To answer this question, we analyzed data of 4,221 persons from Germany.
Dr. Richard Schwab[/caption]
Richard J. Schwab, MD
Professor, Department of Medicine
Division of Sleep Medicine
Pulmonary, Allergy and Critical Care Division
Co-Director, Penn Sleep Center
University of Pennsylvania Medical Center
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Schwab: Hypoglossal nerve stimulation is a pacemaker (a tiny generator and a sensing lead) placed in the right side of the chest, but instead of using electrical pulses to control the heart, the device stimulates the hypoglossal nerve which is the nerve that controls the motion of the tongue. Patients use a remote control to turn on the device before going to sleep and turn it off upon waking up. Stimulation of the tongue moves the tongue forward which enlarges the upper airway.
Dr. David Earnest[/caption]
David Earnest, Ph.D.
Professor in the Department of Neuroscience and Experimental Therapeutics
Texas A&M Health Science Center College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Earnest: When body clocks are disrupted, as they are when people engage in shift work or go to bed and get up at radically different times every few days, more severe ischemic strokes can result.
MedicalResearch.com: What should readers take away from your report?
Dr. Earnest: Whenever possible, go to bed and get up at the same time each day and keep regular mealtimes. If you do need to keep an irregular schedule, it is especially important to be mindful of stroke risk and try especially hard to eliminate other risk factors, such as hypertension and obesity.
Dr. S. S. Hawkins[/caption]
Summer Sherburne Hawkins, PhD, MS
Assistant Professor
Boston College School of Social Work
Chestnut Hill, MA 02467
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sleep is so important for all of us—especially for children and adolescents as their brains and bodies continue to develop. Inadequate sleep is associated with a number of health problems including obesity, cognitive functioning, and chronic illnesses. Increasing the amount and quality of sleep are public health priorities in the US. Currently, school-aged children are recommended to get at least 10 hours and adolescents to get 9-10 hours of sleep daily. However, less than one third of students report getting 8 or more hours of sleep during the school week and total sleep time decreases from infancy through adulthood.
The new Healthy People 2020 ‘Sleep Health’ target only monitors adolescent sleep and there are no national data for younger children. Thus, there is little known about the age that sleep issues may begin and whether the prevalence of sleep issues is changing over time. Furthermore, only a few studies have examined the social determinants of sleep in children and adolescents, particularly whether there are differences across racial/ethnic and educational groups.
An overarching gap in the literature remains—monitoring sleep and identifying disparities across the life course. Using a nationally-representative sample of US children and adolescents, we examined trends and social determinants of inadequate sleep in 6-17-year-olds.
Dr. Wisit Cheungpasitporn[/caption]
Wisit Cheungpasitporn, MD, Nephrology Fellow
Project mentor: Stephen B. Erickson, MD
Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Cheungpasitporn: The prevention and management of hypertension continue to be major public health challenges. Studies have shown the benefits of napping, including reduction of fatigue and improvement of alertness, mood and work performance. However, there have also been increasing reported associations between napping and cardiovascular disease, diabetes mellitus, strokes, and higher mortality from all causes. The risk of hypertension in adults who regularly take a nap is controversial.
Dr. Ofir Turel[/caption]
Ofir Turel, Ph.D
Professor, Information Systems and Decision Sciences
California State University, Fullerton
Scholar in Residence, Department of Psychology
University of Southern California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Turel: The study emerged as a response to the growing societal concern regarding potentially problematic information system use” lifestyles”, including videogame addiction, among adolescents. Much research in this domain has focused on negative psychological (e.g., reduced wellbeing, depression) and social/life functioning (e.g., reduction in normal activities, diminished school performance). Less is known regarding potential physiological outcomes of videogame addiction.
Interestingly, the increase in videogame addiction-like symptoms among adolescents happened in conjunction with an increase in sleep curtailment and obesity in this population. These are too growing concerns in North America and perhaps elsewhere. Medical research implies that these three phenomena may be related. Hence, we hypothesized that videogame addiction will be associated with increased sleep curtailment and increased abdominal adiposity; and consequently, indirectly, with cardio-metabolic deficits.
Our findings suggest that videogame addiction predicts reduced sleep duration which in turn, predicts increased abdominal adiposity. Abdominal adiposity was associated with increased blood pressure, insulin resistance and triglycerides and reduced high density lipoprotein cholesterol levels. Hence, sleep curtailment is an important mediating factor that helps translating videogame addiction into cardio-metabolic deficiencies.
Dr. Anna Pease[/caption]
Dr Anna Pease
Senior Research Associate
University of Bristol
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Pease: We tried to gather evidence of whether there was an association between swaddling for sleep and SIDS. This was a review, not a new original study, but it is the first time these data have been brought together to try to quantify any risk between swaddling and SIDS. We only found 4 studies and they were quite different making it difficult to pool the results. We did find, however, that the risk of SIDS when placing infants on their side or front for sleep increased when infants were swaddled.
Dr. Jean Philippe Chaput[/caption]
Jean-Philippe Chaput, Ph.D.
Assistant Professor of Pediatrics, University of Ottawa
Research Scientist, Healthy Active Living and Obesity Research Group
Children’s Hospital of Eastern Ontario Research Institute
Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Chaput: Folklore has associated behaviors of animals and humans, and even werewolves, to moon phases of the lunar cycle. However, the empirical evidence that the moon exerts an influence on behaviors is weak and very limited. In order to verify if the full moon is associated with sleep and physical activity of children (and possibly debunk this myth), we used a 12-country study involving 5,812 participants and providing 33,710 24-hour accelerometer recordings of sleep and activity behaviors. Overall, we observed that sleep duration was 5 minutes (1%) shorter at full moon compared to new moon, while activity behaviors were not significantly associated with the lunar cycle in this global sample of children drawn from all inhabited continents. However, the magnitude of this effect on sleep duration is unlikely to be clinically significant from a public health standpoint and people should stop worrying about the full moon.
Dr. Maurice Ohayon[/caption]
Maurice M. Ohayon, MD, DSc, PhD
Chief of the Division of Public Mental Health and Population Sciences
Director of the Stanford Sleep Epidemiology Research Centre (SSERC)
John-Arrillaga PI & Professor of Psychiatry and Behavioral Sciences
School of Medicine, Stanford University
Palo Alto, CA 94303
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ohayon: Artificial Lights at night are known to be powerful disruptors of the normal sleep/wake cycle. Light exposure at night acts on suppressing and delaying melatonin secretion and exciting the central nervous system.
In this study we focused on the effects of the outdoor lights at night, (such as street lights and lights, outdoor light fixtures and advertising boards) as measured at nighttime by satellite observations.
We analyzed the sleep habits of a representative sample of the American general population that had been interviewed with the artificial intelligence system Sleep-EVAL.
We found that individuals living in areas at high level of radiance, such as can be found in the downtowns of metropolitan areas, have a delayed bedtime, delayed wake up time and, overall, shorter sleep duration, than people living in areas with low nighttime radiance.
Dr. Stefanos Kales[/caption]
Stefanos N. Kales, MD, MPH, FACP, FACOEM
Associate Professor, Harvard Medical School &
Harvard TH Chan School of Public Health
Director, Occupational Medicine Residency
Division Chief OEM, Cambridge Health Alliance
MedicalResearch: What is the background for this study?
Dr. Kales: Up to 20% of all large truck crashes are due to drowsy or fatigued driving, which would account for almost 9,000 fatalities and up to 220,000 serious injuries. OSA is the most common medical cause of excessive daytime sleepiness or fatigue, and has been linked with negative impacts on attention, working memory, vigilance, and executive functioning. Past studies primarily of passenger car drivers have linked untreated OSA with a several-fold increased risk of motor vehicle accidents. They have also shown that effective treatment with CPAP reduces this risk close to that of unaffected drivers.
Although commercial truck drivers undergo a biennial examination to determine their medical fitness to safely operate a vehicle, there are currently no mandatory standards for OSA screening or diagnosis, in part because there have been no large-scale studies evaluating the crash risk of commercial drivers diagnosed with OSA.
Our study examined the results of the first large-scale employer program to screen, diagnose, and monitor OSA treatment adherence in the U.S. trucking industry
Dr. Jonathan Shaw[/caption]
Jonathan Shaw MD, FRACP, FRCP (UK), FAAHMS
Associate Professor
Domain Head, Population Health Research
Baker IDI Heart and Diabetes Institute
Melbourne VIC 3004
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Shaw: Over the last decade or so, there has been a lot of research connecting obstructive sleep apnoea with type 2 diabetes. They co-exist very frequently in the same individual, they are both much more common in overweight and obese people than in people of healthy weights, both improve with weight loss, and both are associated with other conditions such as hypertension and heart disease. In addition, there has been evidence that some of the key abnormalities occurring in sleep apnoea (in particular, fragmented sleep and intermittent low oxygen levels) may have a direct effect on glucose metabolism, and increase blood sugar levels. This led many people to suspect that untreated sleep apnoea might be one reason that type 2 diabetes is hard to control, and that treating sleep apnoea in people with type 2 diabetes would improve their blood sugar control.
We, therefore, undertook a large trial among people with type 2 diabetes, and previously unrecognised sleep apnoea, in which participants were randomised to either a group receiving specific treatment for sleep apnoea (continuous positive airways pressure, or CPAP, therapy at night) or to a control group.
Over the six months of the trial, we saw no benefit of CPAP therapy in regard to blood sugar control (as measured by HbA1c). Even when we looked at sub-groups with worse blood sugar control at the start or worse sleep apnoea or who did the best in terms of using CPAP every night, there was still no sign of benefit on blood sugar control. We did, however, see some other benefits of CPAP therapy, with less daytime sleepiness, improvements in quality of life and lower diastolic blood pressure.
Dr. Alice Gregory[/caption]
Alice Gregory PhD
Department of Psychology
Goldsmiths, University of London
London, UK
Medical Research: What is the background for this study? What are the main findings?
Dr. Gregory: Sleep paralysis involves a total inability to move just as someone is falling asleep or waking up. This experience typically ends within seconds to minutes and is not usually a sign of any wider problem – yet it can be extremely frightening. This is in part because this experience is often accompanied by hallucinations.
To understand what is happening during episode of sleep paralysis it is useful to understand that there are different stages of sleep. One distinction is between Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep. During REM sleep the body is paralysed. Dreaming often occurs during REM sleep, so it has been proposed that this paralysis keeps us safe, by preventing us from ‘acting out our dreams’. During an episode of sleep paralysis, someone may have woken up but has retained certain features of REM sleep (specifically the paralysis and sometimes dream-related hallucinations).
While sleep paralysis is rather common and the public seem incredibly interested in learning more about this, it is surprising that there is such little research on this topic.
Certain risk factors for sleep paralysis have been proposed previously, such as experiencing stress. However, those suffering from this experience are keen for more information, which is currently unavailable. For this reason, we wanted to see whether we could identify other factors which were associated with sleep paralysis.
Furthermore, in reviewing the literature, we were stunned that while it seems obvious that genetic differences between people are likely to be important in explaining why certain people experience sleep paralysis and others do not – there was almost no work on this topic. We decided to investigate this further as well.
Dr. Donald Wilson[/caption]
Donald A. Wilson, Ph.D.
Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology
NYU Langone Medical Center
Senior Research Scientist
Nathan Kline Institute for Psychiatric Research
Medical Research: What is the background for this study? What are the main findings?
Dr. Wilson: Fetal alcohol spectrum disorder (FASD) is characterized by cognitive, emotional and behavioral problems that are life-long. Generally, it is assumed that the initial trauma of alcohol exposure at a critical time in life is the cause of these problems. In this study using an animal model of FASD, we find that developmental alcohol causes a life-long disturbance in sleep. Given that sleep is important for memory and emotion, among other things, this suggests that developmental alcohol can produce a daily insult to the brain, far outlasting that initial exposure. Each night, the brain is unable to store memories, adjust emotional circuits, remove waste products, in the way that it should, because FASD has disrupted sleep.
Prof. Helen Burgess[/caption]
Helen J. Burgess, Ph.D.
Professor, Departments of Behavioral Sciences & Internal Medicine
Director, Biological Rhythms Research Laboratory
Director, Center for Clinical Chronobiology
Rush University Medical Center
Chicago IL 60612
Medical Research: What is the background for this study? What are the main findings?
Dr. Burgess: The 24 hour circadian clock in the brain has a profound influence on mental and physical health. Circadian rhythm sleep disorders occur when the internal circadian clock’s timing is out of synch with the external social world, which often dictates when we should eat, work and sleep. One such disorder, delayed sleep phase disorder, occurs when the circadian clock runs too late relative to social time.
Patients with delayed sleep phase disorder can appear to simply have insomnia, but careful measurement of their circadian timing can reveal the underlying circadian cause. Also, the treatment of delayed sleep phase disorder with either bright light and/or melatonin can be optimized by knowing a patient’s circadian timing, because the effect of these treatments can vary widely depending on when they are administered.
A problem in the sleep and circadian field is that the gold standard marker of circadian timing in humans, the dim light melatonin onset (DLMO), is typically only measured in the clinic or laboratory. Many clinics do not even measure the DLMO. Our group recently developed a home saliva collection kit to assist people in measuring their DLMO at home. Previously, we found the home DLMOs compared very well to laboratory DLMOs in healthy controls. In this paper, we extended this work to show the kit also works well in patients with delayed sleep phase disorder.