Comparing the modified at-home assessment of dim light melatonin onset with the in-laboratory dim light melatonin onset timing

Xie Chen, Ran Wang, Forrest Tin Wai Cheung, Amy Wing Yin Ho, Chung Shun Ho, Ngan Yin Chan, Joey Wing Yan Chan, Wai Kai Hou, Sonata Suk-Yu Yau, Fiona Yan Liu, Tatia Mei-Chun Lee, Shirley Xin Li, Yun Kwok Wing

Abstract

Introduction To investigate whether the modified at-home dim light melatonin onset (DLMO) assessments would be comparable to the in-laboratory DLMO assessments in terms of feasibility and accuracy.

Methods Fifty-five subjects participated the at-home DLMO assessment (Mean age: 30.85 years, 67.3% female) while 55 age- and sex-matched participants joined the in-laboratory group (Mean age: 29.58 years, 67.3% female). Each participant was instructed to wear actiwatch and document sleep diary for 14 days, and receive polysomnography and DLMO assessment at different nights in the laboratory or at home. The DLMO assessment started from 6 hours before participants’ habitual bedtime as calculated by sleep diary, to 2 hours after their habitual bedtime. During the home assessment, each participant was required to collect salivary samples every 30 minutes, and self-reported sampling time to research staff through text messages immediately after collecting each sample, and the actiwatch was uncovered throughout the assessment for dim light monitoring. The DLMOs and compliance to the sampling time and dim lighting were compared between two groups. The at-home and the in-laboratory DLMO was correlated using both absolute and relative threshold.

Results Overall, the at-home and in-laboratory DLMO (Absolute threshold: r = 0.47; Relative threshold: r = 0.47) were moderately correlated, and the at-home DLMO differed on average by 0.27 hour (16.2 minutes) when using absolute threshold, and 0.62 hour (37.2 minutes) when using relative threshold. The compliance to the scheduled sampling time was 69.1% in the At-home group, significantly lower than the observed 89.1% in the laboratory. The compliance to dim lighting was higher in the at-home group (<20 lux throughout the assessment: 81.6% at home > 53.8% in the laboratory, p<0.01).

Conclusion Our modified at-home assessment of DLMO was a feasible and comparable alternative to in-laboratory DLMO assessment.

Recommended citation: Chen, X., Wang, R., Cheung, F. T. W., Ho, A. W. Y., Ho, C. S., Chan, N. Y., ... & Wing, Y. K. (2024, September). Comparing the modified at-home assessment of dim light melatonin onset with the in-laboratory dim light melatonin onset timing. Journal of Sleep Research, 33(Suppl.1).