Melatonin treatment in circadian rhythm sleep-wake disorders: towards personalized sleep medicine

This dissertation evaluates and describes techniques to promote personalised medicine in circadian rhythm sleep disorders. The most important technique described is salivary melatonin analysis to calculate the Dim Light Melatonin Onset (DLMO = the time of melatonin secretion). The DLMO is used for diagnosis and fine tuning of therapy. Although this dissertation shows that DLMO measurement is accurate, it also shows that a sleep diary and polysomnography do not accurately predict the DLMO. Melatonin is a very effective treatment for circadian rhythm sleep disorders, provided that the DLMO is taken into account when administering melatonin. Melatonin is available as an over-the-counter medicine. However, this is less useful because it is usually taken without the necessary knowledge