About the Test
Purpose of the test
The purpose of the test is to supplement a physician’s evaluation of sleep disturbances and disruption. The test is designed to measure certain hormones such as melatonin and cortisol.
Purpose of an at-home stress and sleep test
While these tests may assist in the identification of specific hormone patterns, they are not consistently recommended for all patients with sleep problems. In addition, the scientific evidence for their utility is limited.
If you have persistent or severe problems with stress or sleep that are affecting your daily life, you should talk with a doctor who can review your symptoms and health history to determine the most appropriate testing for your situation.
Purpose of a physician-ordered stress and sleep test
Cortisol and melatonin testing may be ordered by a doctor as part of the diagnosis of other medical conditions. Cortisol levels can reflect the function of the adrenal glands, and Cushing syndrome is a condition caused by excess cortisol production. Melatonin levels may be tested in the diagnostic process for circadian rhythm sleep-wake disorders. When used to help diagnose these types of conditions, melatonin and cortisol tests are conducted in a medical setting instead of with an at-home kit.
What does the test measure?
As marketed for at-home use, stress and sleep panel tests measure several hormones that are naturally produced by the body. The two principal hormones measured are cortisol and melatonin.
Cortisol is produced by the adrenal glands, which are located above the kidneys and help regulate your response to stress, blood pressure, immune reaction and metabolism. Levels naturally fluctuate over the course of the day, but cortisol production increases in response to stress. This is why it is sometimes called the stress hormone.
Melatonin is made by the pineal gland in the brain. Melatonin production increases with dim light or darkness. It helps to regulate sleep and maintain the body’s 24-hour internal clock, which is known as circadian rhythm. Melatonin levels normally rise at night and fall during the day.
These hormones can be measured in various ways. For at-home tests, they are typically measured in saliva or urine. Because levels naturally vary during the day, the test kit includes instructions for collecting saliva or urine samples at several specific intervals.
The stress and sleep panel tests may take additional measurements in addition to cortisol and melatonin, including:
- Cortisone: Cortisone is produced when cortisol is metabolized, so the ratio of cortisol to cortisone can indicate abnormalities in that process.
- Creatinine: Creatinine is a byproduct of the creation of energy that your muscles need. It is created and excreted in urine at a generally consistent rate. As a result, it can be evaluated with other measurements in urine tests to enhance the reliability of the test result. It is not measured in stress and sleep tests that use saliva.
Benefits and Downsides of the At-Home Stress and Sleep Test
When considering the at-home stress and sleep panel, it is important to be aware of both potential benefits and downsides.
Benefits of this type of at-home testing include:
- Testing on your terms: Because you can conduct the test at home, you do not have to make an appointment or travel to a doctor’s office or laboratory.
- Up-front pricing: The full cost of the test, including shipping, the test kit, and analysis, is usually included in the listed price.
Potential downsides of this testing include:
- Several samples are needed: In order to monitor hormone levels over the course of the day, you will need to budget time in your schedule for each sample collection. Repeated sample collection may make taking the at-home test less convenient.
- Potential for errors in sample collection: It is important to carefully follow any instructions for collecting either saliva or urine samples. Improperly preparing the sample can cause abnormal or unclear test results.
- Unknown test validity: Measuring cortisol and melatonin is not a significant part of a doctor’s evaluation of your stress or your sleep. Even though these hormones are involved in those aspects of your health, research about the accuracy and interpretation of this kind of testing remains limited.
- Out-of-pocket cost: This testing may not be covered by insurance, which means you may have to pay for the full cost yourself.
Types of At-Home Tests
Although not well-established through current medical research, at-home stress and sleep panel tests are offered by several different companies. Below is an overview of the top options in at-home sleep and stress testing:
Best Overall
Everlywell – Sleep and Stress Test
Price: $199
Type: Self-collection
Sample: Dried urine
Tests for: Cortisol, Cortisone, Melatonin, Creatinine
Results timeline: Within several business days
Everlywell’s Sleep and Stress Test includes measurements of cortisol, cortisone, melatonin, and creatinine. Taking the test involves collecting a sample of urine at four specific times of the day: morning, afternoon, early evening, and at night.
The test kit includes instructions and all of the required materials to prepare your sample and mail it to the lab. The purchase price covers shipping both ways.
By including cortisone, Everlywell offers one of the broadest sets of sleep and stress measurements. In addition, measuring creatinine also enables the lab to detect potential problems with your urine samples that could affect test results.
Everlywell’s labs are CLIA-certified and provide timely analysis, offering results within a few business days. The results are displayed clearly on Everlywell’s app, and the company offers webinars with doctors to learn more about sleep and stress hormone testing.
As an added benefit, Everlywell offers discounted pricing for people who subscribe to take this test on a regular basis.
Best Improvement Plan
Thorne – Sleep Test
Price: $200
Type: Self-collection
Sample: Dried urine
Tests for: Cortisol, Melatonin
Results timeline: Within 8 to 10 business days
The Thorne Sleep Test uses four separate urine samples provided over the course of one day to measure your 24-hour cortisol and melatonin levels.
This is a self-collection test, so you will follow the instructions in the test kit to prepare your samples at home and then send them to a certified laboratory. Results are available online within 8-10 business days.
To help you understand your test results, Thorne provides a clear and intuitive online interface for reviewing your hormone levels. Your test report is reviewed by a doctor, and the company also applies an AI technology—its OneGevity Health Intelligence platform—to offer an actionable improvement plan based on your results.
The test kit comes with all of the materials needed to prepare your samples, and all shipping costs are covered in the purchase price. Thorne uses laboratories that are certified by the CLIA and/or the College of American Pathologists (CAP).
Fastest Results
myLAB Box – Sleep + Stress Test – save 20% by using code Testing20 at checkout
Price: $199
Type: Self-collection
Sample: Saliva
Tests for: Cortisol, Melatonin
Results timeline: Within 2 to 5 days
The Sleep + Stress Test from myLAB Box offers convenient testing of cortisol and melatonin levels using saliva samples that are obtained at four separate times during the day.
For most people, obtaining saliva samples, which involves spitting into a provided test tube, is faster and more convenient than preparing a dried urine sample.
Once you have collected your four samples at the specified times throughout the day, you will use a prepaid mailer to send them to myLAB Box.
A laboratory that meets federal standards for CLIA-certification will analyze your samples. The test report with your hormone levels is accessible online within 2-5 business days.
The myLAB Box Sleep + Stress Test comes with free two-day initial shipping, which, combined with the fast laboratory turnaround time, makes their test a leading option for people who want to prioritize getting their results quickly.
Easiest Sample Collection
RxHomeTest – Sleep & Stress Test
Price: $199.99
Type: Self-collection
Sample: Saliva
Tests for: Cortisol, Melatonin
Results timeline: Within 5 to 7 business days
The Sleep & Stress Test from RxHomeTest is a top choice for people who want to measure their cortisol and melatonin levels with a simple and convenient saliva sample.
RxHomeTest uses a self-collection kit, so you will prepare your samples at home and then send them to a CLIA-certified laboratory, where they can be analyzed. Shipping of the test to your home and return shipping of your samples to the lab are both included in the purchase price.
This stress and sleep test measures cortisol and melatonin in your saliva. To track how those levels change during the day, you’ll collect separate samples in the morning, afternoon, early evening, and at night. The test kit includes four test tubes that you spit into at the specified times.
You can access results from RxHomeTest online. They are normally available within 5-7 business days after your sample arrives at the lab.
Most Detailed Results
ZRT Laboratory
Price: $245
Type: Self-collection
Sample: Dried urine
Tests for: Cortisol, Cortisone, Melatonin, Creatinine
Results timeline: Within 5 to 7 business days
The Sleep Balance Test from ZRT Laboratories includes measurements of cortisol, cortisone, melatonin, and creatinine. By including these four measurements, this test offers more data to analyze your daily hormone levels.
The test includes a kit and instructions for taking urine samples at four distinct times: morning, afternoon, early evening, and at night. This allows you to track how your hormone levels change over the course of a normal day. You then ship the samples to the lab with a provided and prepaid package.
Results are available within 5-7 business days after the sample arrives at the lab. The test report clearly shows your hormone levels and provides graphs, charts, and a detailed written description to help you understand the results.
Testing is done in a CLIA-certified lab, and ZRT Laboratories has a strong track record of published studies and research collaborations to develop and validate techniques for at-home hormone testing
Interpreting At-Home Test Results
Your results will be available after the laboratory has analyzed your at-home kit. The test report will show the levels recorded for each component of the test. It will also likely list whether the laboratory considers each level to be low, normal, or high.
Consumers taking this test should be aware of potential challenges and complications that can arise in interpreting this test report:
- Possible errors in the test sample: Test results may be thrown off if the instructions for taking saliva or urine samples were not closely followed. In the home environment, it is easier for accidental contamination, mishandling, or mistiming to occur when taking samples.
- One day of results may be misleading: While the test tracks your levels over the course of one day, that day may not be representative of your typical hormone levels.
- External factors can change hormone levels: Infections, stress, and various types of medications or dietary supplements, including melatonin supplements, may affect hormone levels and make it harder to evaluate your body’s usual amount of hormone production.
- Test interpretation is poorly defined: The lack of research studies about this testing limits your ability to interpret these results. These tests should be considered in the context of other symptoms and with the support or guidance of a doctor.
- Follow-up testing is likely necessary: These tests are not able to diagnose any medical conditions on their own, and abnormal levels will likely require additional testing overseen by a doctor.
It is important to talk with a doctor if you are concerned about your sleep, stress, or hormone levels. Depending on your symptoms, your doctor can work with you to find the right test or series of tests to better understand the problem and identify an appropriate treatment.
