OBJECTIVE We aimed to compare the sleep onset, dim light melatonin onset (DLMO) and phase angle (PA) between sleep onset and DLMO of insomnia patients with those of controls, and to examine the difference in these parameters in relation to objective sleep quality. METHODS Participants were recruited from three Public Health Centers in Korea. Actigraphy recordings were conducted for seven days. Five hourly saliva samples were obtained from three hours prior to sleep onset. A total of 48 controls and 64 insomnia patients were analyzed. Nocturnal sleep parameters, DLMO, and PA were compared between the controls and insomnia patients, and between the controls and patients with difficulty in maintaining sleep (DMS). These sleep and circadian parameters were compared among the subgroups divided by wake after sleep onset (WASO) amount. RESULTS There were no significant differences in sleep parameters between the control and insomnia groups, and between the controls and DMS subgroup. The sleep onset, DLMO, and PA of the insomnia group or those of DMS subgroup were not different from those of controls. There were significant differences in the sleep onset and DLMO (p < 0.05) among mild, moderate, and severe WASO groups. A regression analysis revealed the earlier DLMO and shorter PA predicted the severity of WASO (p < 0.0001) in total participants. CONCLUSIONS Insomnia patients exhibited no difference in their sleep timing and melatonin rhythm compared to controls. However, these circadian parameters varied depending on the severity of WASO, and advanced melatonin phase and its shortened phase angle were associated with worsening of sleep maintenance.

中文翻译：

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睡眠中断与社区居住成年人的昼夜节律相和相角改变有关。

目的我们旨在比较失眠患者的睡眠发作，昏迷褪黑素发作（DLMO）和相角（PA）与对照者之间的相角（PA），并检查这些参数与客观睡眠质量之间的差异。方法从韩国的三个公共卫生中心招募参与者。书法记录进行了7天。从睡眠开始前三个小时获取五个小时的唾液样本。总共分析了48位对照和64位失眠患者。比较对照组和失眠患者以及对照组和难以维持睡眠的患者（DMS）的夜间睡眠参数，DLMO和PA。比较这些亚组之间的睡眠和昼夜节律参数，除以睡眠开始后的苏醒（WASO）量。结果对照组和失眠组之间以及对照组和DMS亚组之间的睡眠参数无显着差异。失眠组或DMS亚组的睡眠发作，DLMO和PA与对照组无差异。在轻度，中度和重度WASO组之间，睡眠发作和DLMO有显着差异（p <0.05）。回归分析显示，较早的DLMO和较短的PA预测了总参与者中WASO的严重程度（p <0.0001）。结论与对照组相比，失眠患者的睡眠时间和褪黑激素节律没有差异。但是，这些昼夜节律参数根据WASO的严重程度而有所不同，褪黑激素阶段的进展及其相角的缩短与睡眠维持的恶化有关。