A study of adolescents with attention-deficit/hyperactivity disorder found that a home-based saliva test may be effective in measuring melatonin onset, a key marker of circadian rhythm.
The protocol was successful in 92% of participants, suggesting at-home testing may be a viable alternative to laboratory-based assessments.
Researchers evaluated whether adolescents could complete a dim-light melatonin onset (DLMO) procedure at home after 5 nights on a fixed sleep schedule. They recruited 60 participants aged 10 to 15 years with varying levels of attention-deficit/hyperactivity disorder (ADHD) symptoms. Each followed a structured routine and collected saliva samples every 30 minutes over 4.5 hours in dim-light conditions.
The participants were grouped by ADHD symptom severity using the Conners-3 Parent Index: 28 were classified as having higher symptom levels (ADHDy), and 32 as lower (ADHDn). DLMO was identified in 96% of the participants in the ADHDy group and 87% of those in the ADHDn group.
In total, melatonin onset was successfully measured in 55 participants. Among the remaining five, three had melatonin levels that remained too high during testing, and two had issues related to sample quality or measurement error.
Each participant received a collection kit with instructions, saliva tubes, a small scale, a logbook, an ice pack, and light-blocking glasses. Staff provided instructions via video call, reminded participants every 30 minutes to collect samples, and documented sample timing and weight. Samples were stored in insulated bags and retrieved the following day. Melatonin was measured using radioimmunoassay, with a 4 pg/mL threshold used to determine DLMO timing.
Statistical analysis showed no statistically significant difference in test success between the ADHDy and ADHDn groups, indicating ADHD severity didn't affect the ability to complete the at-home procedure.
The researchers concluded that most adolescents, regardless of symptom severity, were able to follow instructions and complete the saliva collection at home. They noted that this method may reduce the burden of laboratory testing, particularly for children who find such environments challenging.
The study was funded by federal research grants and conducted in collaboration with a sleep research laboratory and university psychiatry departments.
These findings supported the feasibility of at-home circadian rhythm testing in pediatric populations. Future studies may assess its use in broader age ranges and its potential role in guiding treatment for sleep-related concerns in ADHD.
Disclosures were not made available at time of publishing.
Source: Sleep