You’ve taken a critical step to understanding your body’s sleep-wake cycle. Now, it’s important to perform this assessment correctly to maximize the value it will have on your results. As we all lead very different lives, you may need to adjust the test routine to your lifestyle while still maintaining test integrity, as this can directly impact your care. If you have any questions about melatonin testing you can explore the FAQ’s below, but also know that we’re here to help.
What am I supposed to do for X hours while taking the assessment?
Dim light doesn’t mean no light, so you can generally continue with most evening activities as normal with an adjusted lighting environment. However, some people make a special event out of testing to make it more enjoyable. Most people simply enjoy a night of relaxation quiet time, while others enjoy some binge-worthy content on their favorite streaming platform (provided your device brightness is dimmed). Parents will sometimes plan an indoor “camping or fort building day” with their kids, or alternatively, choose a night to themselves. Gamers and workaholics can keep things moving, just by sitting a little further away from their screens, activating dark or night mode, and dimming the brightness down as much as possible, while still being able to work or play. If you have a specific activity that you’re questioning, feel free to reach out and we can help advise you on what might be the best option in your situation.
Why did my sleep health provider choose this test, instead of that one?
Sleep-wake cycles are complex and vary significantly between individuals for a multitude of behavioral, environmental, and physiological reasons. Some providers may be more familiar with interpreting a specific test or have their own methodology for selecting a test that they feel will best fit your specific condition or concern. If you think a different test would suit your purpose better, it’s best to discuss this with your healthcare provider before making a selection.
Will I have to take the test more than once?
In most cases, you will only need to perform one assessment. However, there are specific sleep-wake disorders that can benefit significantly from multiple tests, but usually not more than 2. There is, however, always the potential that if the instructions are not followed precisely, this could negatively impact the outcome of your test. Therefore, it is very important to read through the instructions entirely and ask any questions up front. If anything is unclear or you are not able to complete the test as instructed, our support team has extensive experience with alternative solutions that will maintain the test integrity.
Will test results reveal my chronotype?
Not exactly. An individuals chronotype typically designates a period of time when and individual is most likely to feel alert or obtain the best-quality sleep. However, societal factors like work and school schedules often push individuals to operate outside of their ideal sleep window, leading to discrepancies between their natural chronotype and their actual sleep patterns. While chronotype influences the propensity of an individual’s circadian rhythm to align with specific sleep-wake cycles, the circadian rhythm itself is normally not affixed to an individual’s chronotype-determined sleep period and can be influenced by various factors.
Why do I need to leave the flask uncapped while freezing?
The flask is a vacuum-sealed container that comes pre-loaded with refrigerant. Removing the cap allows air to circulate and reduces the time needed to fully charge the refrigerant, so that your samples stay cold during return shipping. If you leave the cap on the flask, you will need to freeze the flask for an additional 2-3 days before adding your samples.
Taking the Assessment
How “dim” is “dim” light?
If you think of a dimly lit parking lot, or parking garage, this is usually ideal for sample collection. If the light is dim enough, it will require your eyes to adjust to the environment and turning on a light in the same room would cause brief discomfort. It is ideal if you have just enough light to move around and read instructions, but it will be less comfortable than normal. Try to keep this level of lighting as consistent as possible, even when moving between different rooms, as changes in light intensity can also alter your natural melatonin production levels.
What and when can I eat?
While critical foods to avoid eating are listed in the test instructions, for example caffeine and bananas, there are other melatonin-containing foods, such as most fruits, nuts, beans, rice, etc., that can impact melatonin levels as well. In general, most melatonin derived from food is metabolized quickly and does not significantly impact results. However, avoiding food intake, or recording your food intake on the sampling form, can help in optimizing your results.
If you are performing a standard Onset or Offset test, it is best not to eat anything other than small snacks during the testing period. You should eat immediately following a sample collection and wash your mouth out with water as soon as you are finished.
If you are taking a longer test, such as a 24-HR phase map, it is best to eat immediately after providing a sample, so that your body has plenty of time to digest the food before your next sample collection is required.
Can medications or supplements impact the validity of my results?
There are many prescription and non-prescription medications and supplements that can potentially impact the circadian rhythm. However, the impact can be different for everyone based on the formulation, dosage, interactions with other compounds, and their own individual biology. This can become important information for results profiles with atypical production cycles. While we can provide some recommendations, the decision to continue or discontinue supplements/medications before testing should always be discussed with your healthcare provider before making any changes. Many providers will have their own preferences with regards to medications taken while performing an assessment, so it is best to discuss this with them directly.
What happens if I have recently used a Melatonin supplement?
It is recommended that you do not take Melatonin within 3-5 days of taking the assessment for most individuals, and even longer if you are supplementing a high dose of 5 mg or more routinely. Melatonin is made naturally by your body and its production is part of a process that prepares your body for sleep. Much like any drug, people will have different tolerances, and this can also throw off your natural balance. If this is the case, your body may make adjustments to your natural production levels that could take days, or even weeks to fix, even after your stop supplementing. This all depends on your natural biology, the dosage of melatonin you take, and the frequency in which you take it.
Can I sleep during the test?
If you are performing a standard Onset or Offset test, it is generally best to stay awake for the duration of the test. However, if you do fall asleep, it will not impact the quality of the results in most individuals. The main reason we recommend staying awake is because saliva production lowers when you fall asleep, which may make it more difficult to provide a sample after you wake up.
If you are taking a longer test, such as a 24-HR phase map, sleeping in-between samples is common and depends on how your body responds to abrupt awakening. You should give yourself enough time to wake up and get a drink of water, if needed, before having to provide your next sample.
What if I collect my sample late?
This can depend on your test, but it is important to do your best to maintain consistent timing intervals with either the standard protocol, or any custom collection schedule that has been requested by your provider. If you miss a sample completely or have exceeded the recommended times below, you may want to discontinue testing and contact our team for a solution. Here is some generalized guidance:
Onset Assessment – If your samples are being collected every hour, try to keep collections within 20 minutes of the intended time. Even if you are late with one sample, it is best to take your next sample on time.
24-HR Assessment – If your samples are being collected every 2.75 hours, try to keep collections within 1 hour of the intended time. Even if you are late with one sample, it is best to take your next sample on time.
Offset Assessment – If your samples are being collected every 30 minutes, try to keep collections within 15 minutes of the intended time. Even if you are late with one sample, it is best to take your next sample on time.
What happens if I can’t collect enough saliva?
It takes most people less than 5 minutes to collect enough volume for each sample. However, if it’s taking you longer than 15 minutes each to collect a sample, then we have some simple tips you can try in the following order;
- Think about eating your favorite food. This works best if you have been fasting during the test.
- Smell your favorite food. You can purchase your favorite food prior to performing the test and smell it to increase saliva flow.
- If you’re still having trouble reaching that fill line, you can contact us to request a stimulant. While unstimulated saliva is best-practice for collection, stimulation may be necessary as a last resort. Either way, we’re happy to help you out.
What if I miss one sample?
Missing one sample is not critical in returning your results profile. However, this can make the interpretation of your results difficult, depending on if the sample was integral to your specific biological rhythm. For example, missing a sample that is indicative of a peak or phase change could make it difficult to identify these key indicators in your results profile.
Can I nap during a 24-HR Phase Map test?
In most individuals, napping for a short period of time (20-30 mins) does not significantly alter the circadian rhythm. Therefore, napping is generally acceptable during the test, especially if it is part of your daily routine. However, if you are not routinely sleeping during that same time, it is best to stay awake during the assessment so that you do not introduce any unknown variables. Since everyone’s biological makeup is unique, there is always a potential that this could have some impact on your results.
What happens if I exercise during the assessment?
To ensure the accuracy of this test, it is important to maintain your body’s natural balance (homeostasis) and allow your biological melatonin production to take place uninfluenced as much as possible. By doing so, you can better identify any indications of irregular melatonin production that might be present.
In general, regular physical activity has been associated with beneficial effects on sleep patterns and overall circadian rhythm regulation. However, the timing and duration of exercise can influence melatonin levels. For instance, engaging in intense exercise close to bedtime might delay the onset of melatonin secretion and subsequently impact the sleep-wake cycle.
Why can’t I brush my teeth?
Brushing your teeth can create micro-abrasions to the gums, which can leak small amounts of blood into your saliva. Since the concentration of melatonin in saliva is generally 10 to 100 times lower than that in blood, brushing your teeth can substantially increase levels of melatonin in your samples.
What if I don’t return samples on Monday/Tuesday?
If your melatonin levels are sensitive to degradation at room temperature, then failing to ship on a Monday or Tuesday could mean you will need to repeat the test. Samples that are not returned on Monday/Tuesday are at a greater risk of delays or late deliveries. Since the lab is not open on the weekends, having your samples delayed over a weekend will increase the risk of your sample degrading.
Can I still ship my samples back over the holidays?
For optimal results, we do not recommend shipping during a holiday week. It is also best not to ship the week before or after a major shipping holiday such as Christmas, since this can cause shipping delays and interruptions. There is no rush to return samples, as once they are frozen, they can remain in the freezer for an extended period of time. However, we recommend returning samples withing 30 days.
Where are my results?
We generally issue results within 7-10 business days from the date Salimetrics receives your returned samples. This is normally 2-3 days after you ship them back to us. If there are inconsistencies in your sampling form or sample data, we may need to contact you before releasing your results to ensure your data is accurate. This can sometimes require corrections that increase the time it takes us to release results. However, if it has been more than 2 weeks since we received your samples, and you haven’t received any e-mails from our [email protected] email, feel free to contact us and request that we resend your results.
Why are my test results “undetermined”?
Undetermined or indeterminate results happen if no onset or offset is observed during the sampling window. This does not mean that the test has failed or that there was a problem with your collections. Usually this is a result of your body’s own production cycle and simply means that your onset could not be calculated based on the melatonin values in your samples. This could be due to a significant phase delay or advance, or that your body is producing too much or not enough melatonin to make an accurate determination. Alternatively, your physician may have adjusted the sampling schedule to look for a specific melatonin production level at a specific time, so the determination of onset or offset may not be relevant to your specific sleep disruption.
In most cases, this is where you can work closely with your sleep-health provider to better understand how your symptoms may align with your results.