Out-patient care concept for assessment of sleep problems
In Circadian-Rhythm-Sleep-Disorders a considerable shift of the individual circadian rhythm is the concealed, biological reason for the patients symptoms. Sleep Check allows the assessment of circadian rhythm by determining the individual Dim-Light Melatonin Onset (DLMO). The definition of the individual DLMO allows both a confirmed differential diagnosis and the individual timed prescription of therapeutic intervention, therefore this concept can lead to a more precise therapeutic outcome and greater patient satisfaction.
Sleep Check is a complete out-patient care concept for the assessment of Circadian-Rhythm-Sleep-Disorders developed by BÜHLMANN. Sleep specialists and sleep laboratories can adopt this concept to facilitate assessment of individuals with sleep disorders
The analytical determination of the DLMO is based on a partial, 5 point salivary melatonin profile. The client is provided with a collection pack containing five saliva collection devices together with the appropriate instructions enabling the client to collect the samples at home. The samples are collected at hourly intervals around the normal sleep time, over the course of one evening. The samples will be sent to the specified In-vitro diagnostic routine laboratory where melatonin concentrations are determined and the individual DLMO calculated.
The Sleep Check Collection pack can be supplied directly by a Medical Health Specialist (Sleep specialist, Neurologist etc.) during a face-to-face consultation or could be requested directly by the client via Internet facilities. The client could also retrieve results directly from the Internet for discussion with the Sleep Specialist depending on the Sleep Center offering the service.
Content of the Sleep Check collection Pack
|Big Envelope||For shipment to Clients|
|Safety Box||Containing 5 Salivettes incl. Labels|
|Client Manual||Collection Instruction for Clients|
|Client Data Form||Minimal Data required from the Clients|
|Blue Plastic Envelope||For reshipment to the routine laboratory|
|Sleep Check Information||Instruction for Use
|Instruction for Use
|PDF [150 kb]
|PDF [400 kb]
||PDF [170 kb]
DE / FR / IT
* Multilingual document [EN, DE, FR, IT, ]
DLMO - Dim Light Melatonin Onset
Collected samples can be sent to the indicated laboratory where the samples will be analysed either with the highly sensitive Direct Saliva Melatonin radioimmunoassay or the Direct Saliva Melatonin ELISA both supplied by BÜHLMANN.
The laboratory results will be plotted on a time curve with a point to point fit. The DLMO is defined as the point where the salivary melatonin exceeds as specific melatonin concentration.
By complying the prescribed collection times and procedure the partial 5 point profile allows in most cases to define the individual DLMO.
In rare cases the assessment of a 24 hours profiles will be necessary. A significant shift indicates either a Delayed or Advanced Sleep Phase Syndrome, which can be treated either by the correctly timed intake of melatonin or exposure to bright light.
Numerous studies have clearly shown the direct correlation between melatonin and circadian rhythm and its involvement in Circadian-Rhythm-Sleep Disorders. Salivary melatonin concentration directly reflects the physiological melatonin onset in the evening produced by the pineal gland.
The Sleep Check concept has been successfully used for many years at the Gelderse Valley Hospital in Ede, Nederland for the assessment of thousands of patients suffering from sleep disorders. A first evaluation of the clients survey after treatment shows that individual adaptation of treatment gives a great client satisfaction rate.
The sleep clinic in Zurzach/Luzern, Switzerland, started with the Sleep Check concept for the assesment of DLMO.
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