Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain
IntroductionSleep dysregulation is highly prevalent in pediatric chronic pain conditions and associated with poorer clinical outcomes. Interactions between underlying circadian misalignments and pain in pediatric populations remain unclear. Dim-light melatonin onset collections conducted in external...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Sleep |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frsle.2025.1593196/full |
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| author | Nicole Tacugue Jessica J. Love Jessica J. Love Jessica J. Love Jakob M. Cherry Jakob M. Cherry Jacqueline Lane Jacqueline Lane Jacqueline Lane Jacqueline Lane Joe Kossowsky Joe Kossowsky |
| author_facet | Nicole Tacugue Jessica J. Love Jessica J. Love Jessica J. Love Jakob M. Cherry Jakob M. Cherry Jacqueline Lane Jacqueline Lane Jacqueline Lane Jacqueline Lane Joe Kossowsky Joe Kossowsky |
| author_sort | Nicole Tacugue |
| collection | DOAJ |
| description | IntroductionSleep dysregulation is highly prevalent in pediatric chronic pain conditions and associated with poorer clinical outcomes. Interactions between underlying circadian misalignments and pain in pediatric populations remain unclear. Dim-light melatonin onset collections conducted in external lab settings are standard for measuring circadian rhythmicity by examining fluctuations in melatonin levels. However, present limitations prevent us from capturing a typical night's sleep and minimize accessibility to broader populations due to geographic, financial, and temporal barriers. We investigated a novel approach in which participants complete collections in an entirely self-directed manner using an at-home diagnostic kit.MethodsParticipants included pediatric patients with diagnosed chronic pain and healthy controls. The 3-week protocol involved sleep, activity, and light tracking, self-reported sleep diaries, a survey determining morningness-eveningness chronotypes, one self-directed home dim-light melatonin onset collection with objective compliance measures, and assessment of study protocol acceptability.Results and discussionIn a sample of pediatric patients with diagnosed chronic pain (N = 6, Mage=14.5, SD = 2.74, 66.7% female) and a subset of healthy controls (N = 6, Mage =13.3, SD=2.73, 50% female), both the Hockeystick method and 3 pg/ml dim-light melatonin onset threshold were employed to calculate salivary dim-light melatonin onset times in 8 of the 12 participants. On average, dim-light melatonin onset times were 1 h and 43 min earlier than self-reported sleep onset times. Our results illustrate the feasibility and accuracy of self-directed, remote dim-light melatonin onset collections in pediatric populations. With supplementary research validating this optimized approach to measure endogenous circadian phase, more specific aspects of sleep can be targeted in pain intervention strategies to further optimize clinical outcomes in a greater population of pediatric patients. |
| format | Article |
| id | doaj-art-5f2d094ba9654084b2632aa63e9cc9f3 |
| institution | Kabale University |
| issn | 2813-2890 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Sleep |
| spelling | doaj-art-5f2d094ba9654084b2632aa63e9cc9f32025-08-20T03:50:07ZengFrontiers Media S.A.Frontiers in Sleep2813-28902025-07-01410.3389/frsle.2025.15931961593196Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic painNicole Tacugue0Jessica J. Love1Jessica J. Love2Jessica J. Love3Jakob M. Cherry4Jakob M. Cherry5Jacqueline Lane6Jacqueline Lane7Jacqueline Lane8Jacqueline Lane9Joe Kossowsky10Joe Kossowsky11Laboratory for Digital Assessment, Research, and Treatment, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United StatesThe Lane Laboratory, Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United StatesDepartment of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United StatesDepartment of Psychology, University of Wisconsin-Madison, Madison, WI, United StatesThe Lane Laboratory, Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United StatesProgram in Medical and Population Genetics, Broad Institute, Cambridge, MA, United StatesThe Lane Laboratory, Division of Sleep and Circadian Disorders, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United StatesProgram in Medical and Population Genetics, Broad Institute, Cambridge, MA, United StatesCenter for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesLaboratory for Digital Assessment, Research, and Treatment, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesIntroductionSleep dysregulation is highly prevalent in pediatric chronic pain conditions and associated with poorer clinical outcomes. Interactions between underlying circadian misalignments and pain in pediatric populations remain unclear. Dim-light melatonin onset collections conducted in external lab settings are standard for measuring circadian rhythmicity by examining fluctuations in melatonin levels. However, present limitations prevent us from capturing a typical night's sleep and minimize accessibility to broader populations due to geographic, financial, and temporal barriers. We investigated a novel approach in which participants complete collections in an entirely self-directed manner using an at-home diagnostic kit.MethodsParticipants included pediatric patients with diagnosed chronic pain and healthy controls. The 3-week protocol involved sleep, activity, and light tracking, self-reported sleep diaries, a survey determining morningness-eveningness chronotypes, one self-directed home dim-light melatonin onset collection with objective compliance measures, and assessment of study protocol acceptability.Results and discussionIn a sample of pediatric patients with diagnosed chronic pain (N = 6, Mage=14.5, SD = 2.74, 66.7% female) and a subset of healthy controls (N = 6, Mage =13.3, SD=2.73, 50% female), both the Hockeystick method and 3 pg/ml dim-light melatonin onset threshold were employed to calculate salivary dim-light melatonin onset times in 8 of the 12 participants. On average, dim-light melatonin onset times were 1 h and 43 min earlier than self-reported sleep onset times. Our results illustrate the feasibility and accuracy of self-directed, remote dim-light melatonin onset collections in pediatric populations. With supplementary research validating this optimized approach to measure endogenous circadian phase, more specific aspects of sleep can be targeted in pain intervention strategies to further optimize clinical outcomes in a greater population of pediatric patients.https://www.frontiersin.org/articles/10.3389/frsle.2025.1593196/fullpediatricmelatoninchronic paincircadianDLMO |
| spellingShingle | Nicole Tacugue Jessica J. Love Jessica J. Love Jessica J. Love Jakob M. Cherry Jakob M. Cherry Jacqueline Lane Jacqueline Lane Jacqueline Lane Jacqueline Lane Joe Kossowsky Joe Kossowsky Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain Frontiers in Sleep pediatric melatonin chronic pain circadian DLMO |
| title | Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| title_full | Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| title_fullStr | Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| title_full_unstemmed | Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| title_short | Feasibility and acceptability of self-directed, remote dim-light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| title_sort | feasibility and acceptability of self directed remote dim light melatonin onset collection in pediatric patients diagnosed with chronic pain |
| topic | pediatric melatonin chronic pain circadian DLMO |
| url | https://www.frontiersin.org/articles/10.3389/frsle.2025.1593196/full |
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