Melatonin Profile – Saliva

Beschrijving

Clinical focus

The Melatonin Profile provides an overview of a patient’s sleep–wake rhythm by measuring salivary melatonin at several key time points over a single day. It is particularly useful in:

• Difficulty falling asleep or staying asleep
• Early-morning awakening
• Suspected circadian rhythm disorders (e.g. delayed sleep phase, advanced sleep phase)
• Jet lag and shift-work–related sleep problems
• Suspected low nocturnal melatonin output (e.g. with chronic stress, light exposure at night, ageing)
• Mood disorders where disturbed circadian regulation is suspected (SAD, burnout, some depressive pictures)

Melatonin in saliva closely reflects unbound, biologically active melatonin in circulation and provides a practical alternative to blood measurements for assessing circadian timing and overnight secretion.

Analytes

The profile includes four timed melatonin measurements in saliva:

• Melatonin – Morning (approximately 30 minutes after waking)
• Melatonin – Midday (before lunch)
• Melatonin – Evening (before dinner)
• Melatonin – Night (shortly before going to bed)

This pattern allows assessment of:

• Daytime suppression of melatonin
• Onset and rise of evening melatonin
• Adequacy of nocturnal peak secretion

Sample and collection

Sample type: Saliva, 4 tubes (patient home collection) Rupa Health+1

Collection day: 1 day.

Standard collection schedule (example): Rupa Health

1. Morning sample – 30 minutes after waking, before breakfast
2. Midday sample – before lunch
3. Evening sample – before dinner
4. Night sample – just before going to bed

General instructions:

• No food or drink (except water) for 1 hour before each collection
• No brushing or flossing teeth for 30 minutes before sampling
• Rinse the mouth with water, wait 10 minutes, then collect saliva into the tube
• Fill each tube to the indicated mark, close firmly, label with date and time

Specific restrictions (you can adapt to your WHL SOP):

• Avoid melatonin supplements for at least 36 hours before the first sample
• On the collection day avoid caffeine, energy drinks and non-essential supplements/medications that may interfere with melatonin (unless medically necessary)

Handling and shipping

• After each collection, place the tube immediately in the freezer
• Keep all tubes frozen together with the cold pack until shipment
• Ship the samples with the provided insulated packaging and cold pack, using the return label included in the kit
• Prefer early-week shipping so samples do not sit over the weekend in transit

Interpretation – typical patterns

The report will usually comment on:

• Normal profile: low daytime values with a clear rise in the evening and highest values at night
• Low nocturnal melatonin: may be associated with insomnia, ageing, excessive evening light exposure, beta-blocker use, or chronic stress
• Elevated daytime melatonin: can indicate circadian phase shift, inappropriate supplement timing, or sampling artefact
• Phase delay or advance: shift of the evening/night peak later or earlier than expected, relevant in delayed sleep phase syndrome, shift-work and jet lag
• These patterns are interpreted in the context of symptoms, medication/supplement use, and, if available, parallel cortisol or sleep questionnaires.

Scientific background

Melatonin is a pineal hormone with a strong circadian pattern, peaking at night and suppressed by light. Salivary melatonin correlates well with plasma melatonin and is widely used for assessing dim-light melatonin onset (DLMO) and circadian phase in clinical and research set