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Contactless, self-directed, at-home salivary DLMO assessment is feasible and reliable for measuring circadian phase in adults with circadian rhythm disorders and healthy controls

The study tested a self-directed, home-based, contactless salivary DLMO protocol in 10 participants (5 with circadian rhythm disorders, 5 controls). Valid DLMOs were obtained in 14/20 assessments, with 8/10 participants having at least one valid DLMO and 6/10 having two. The first and second DLMOs were strongly correlated (r=0.98, p<.001), and the protocol detected clinically relevant differences in circadian timing.

Last updated: Sep 1, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Feasibility of a contactless, self-directed, home-based dim-light melatonin onset protocol: the Circadia pilot study.

observational

Bormes G, Love JJ, Burns AC, Akeju O, Cherry JM, Kantesaria N, Kunorozva L, Qadri S, Rahman SA, Scheer FAJL, Westover B, Winkelman JW, Saxena R, Lane JM · Sleep advances : a journal of the Sleep Research Society (2026)

Participants: N/A
Duration: 4-6 weeks
Intervention: Self-directed, at-home, contactless salivary DLMO assessment protocol with mailed kits and online portal
Outcome: Feasibility (compliance, confidence), DLMO timing, test-retest reliability
Effect Size: N/A
Population: Adults aged 27-63 with Circadian-Rhythm Sleep-Wake Disorders (n=5) and healthy controls (n=5)

Result:

PubMed: 42662684DOI: 10.1093/sleepadvances/zpag081

Mechanism Graph

Participants receive mailed kit and access online portal
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They track sleep, activity, and light for 4-6 weeks
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They collect saliva samples at home at specified times for DLMO
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DLMO is calculated from salivary melatonin levels

Limitations

  • ⚠Small sample size (n=10)
  • ⚠High failure rate (6/20 assessments failed) due to compliance errors or melatonin levels
  • ⚠No comparison to in-lab DLMO assessments

Frequently Asked Questions

What is DLMO and why is it important?▼

DLMO (dim light melatonin onset) is a marker of endogenous circadian phase, used to assess circadian rhythm disorders.

How many participants had valid DLMO results?▼

Valid DLMOs were obtained in 14 out of 20 assessments, with 8 out of 10 participants having at least one valid DLMO and 6 out of 10 having two.

What were the main reasons for DLMO failures?▼

Failures were due to compliance errors (e.g., bright light exposure) or melatonin levels consistently below or above threshold.

How reliable was the at-home DLMO protocol?▼

The first and second DLMOs were strongly correlated (r=0.98, p<.001), indicating high test-retest reliability.

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References

  1. 1.Bormes G, Love JJ, Burns AC, Akeju O, Cherry JM, Kantesaria N, Kunorozva L, Qadri S, Rahman SA, Scheer FAJL, Westover B, Winkelman JW, Saxena R, Lane JM. "Feasibility of a contactless, self-directed, home-based dim-light melatonin onset protocol: the Circadia pilot study.." Sleep advances : a journal of the Sleep Research Society, 2026. PMID: 42662684 DOI: 10.1093/sleepadvances/zpag081
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.