Salive Specimen Collection Instructions

Attachment 12

Saliva Specimen Collection Instructions

IMPORTANT: Please read the attached instructions before you complete this form.

Please fill out this chart below, and answer the question at the bottom of the page when you are

collecting your saliva (spit) samples.

Date of Saliva Sample Collection: ______________________
Is today a weekday or a weekend day?	 Weekday  Weekend
	Time
At what time did you go to bed yesterday?	a.m. / p.m.
At what time do you usually go to bed?	a.m. / p.m.
At what time did you take sample #1 (Awakening)?	a.m. / p.m.
At what time did you take sample #2 (+30 Minutes)?	a.m. / p.m.
At what time did you take sample #3 (+45 Minutes)?	a.m. / p.m.
At what time did you take sample #4 (+60 Minutes)?	a.m. / p.m.

Please indicate how you would rate your sleep last night with an X in one of the sections on the line:

Worst Possible Sleep

Best Possible Sleep

I----------------I-----------------I-----------------I------------------I-----------------I----------------I

Saliva (Spit) Collection Instructions

We have provided supplies for you to collect 4 samples of your saliva (spit).

Please read these instructions completely before you handle these supplies.

We are collecting saliva (spit) to learn about stress hormones and to see if there are differences between tired and not tired people.

In the box that we sent you, there is a bag that has a white plastic bottle holding small tubes with 4 cotton swabs for saliva (or spit) collection. DO NOT open the bottle until it is time to collect saliva (spit).

Figure A

Your saliva (spit) kit contains these items:

• 1 White bottle containing 4 small tubes with cotton swabs (Figure A)

• 4 Long tubes that are labeled. (Figure B)

• 1 Saliva (spit) collection form (on pink paper)

• These instructions

Figure B

What You Need To Be Careful About

We appreciate your help in collecting unspoiled saliva specimens. We ask that you:

• Do not open the bottle until you are ready to collect saliva (spit) samples. Dampness in the air may affect the samples.

• Do not smoke, drink, or eat during the one-hour saliva (spit) collection period.

• Do not brush your teeth until after you have collected all four saliva (spit) samples.

Collection Rules

1. Collect the samples within 3 days of your clinic visit.

For example, if your clinic visit is set for Friday, you can collect the saliva samples on Tuesday, Wednesday, or Thursday.

2. Be sure to collect the samples before the day of your clinic visit.

Please do not wait until the day of your clinic visit to collect these samples. But if you do, we understand.

3. Collect all saliva (spit) samples on the same day.

4. Collect all saliva (spit) samples within 1 hour of waking up.

Place the white bottle at your bedside before you go to bed so that it will be easy for you to collect the first sample.

• 1^st saliva (spit) sample—upon waking up. Please collect the saliva sample as soon as you wake up and before you get out of bed.

• 2^nd saliva sample—30 minutes after waking up

• 3^rd saliva sample—45 minutes after waking up

• 4^th saliva sample—60 minutes after waking up

For example, if you wake up at 6:45 am, you will collect the saliva (spit) samples at 6:45 am, 7:15 am, 7:30 am, and 7:45 am.

5. Carefully remove one tube from the bottle and remove the cotton swab from the tube.

IMPORTANT: To help you collect the saliva (spit) at the correct time, the bottle cap of the bottle has a computer chip that tells us the exact time when the bottle is opened. Please open the bottle only when you are about to collect a sample and only take out one tube at a time. Otherwise, the chip will tell us the wrong times for your saliva (spit) samples.

• Remove the lid from the bottle. Take out one tube at a time and place the cap back on the bottle. Remove the tube’s cap and empty the cotton swab in your mouth. Be careful not to touch the cotton swabs so that you don’t spoil your samples.

6. Chew each cotton swab for 60 seconds, until the cotton swab is soaked.

7. Spit the cotton swab back into the small tube and put the cap back on the tube.

• Put the first cotton swab you chewed (immediately after waking up) back into the small tube without touching the swab (that is, pass the swab directly from your mouth to the tube).

• P

  Figure C

  

  lace the cap back on the small tube.

8. Properly store your sample.

• Put the small tube into the longer tube #1 (Awakening). [Figure C]

• Press down on the cap. [Figure D]

• Repeat these steps for the remaining saliva (spit) samples. Put the second chewed swab (30 minutes after waking up) into long tube #2 (+30 min), the third chewed swab into long tube #3 (+45 min), and the fourth chewed swab into long tube #4 (60 min).

Figure D

9. Write down the time of your samples.

As you chew each swab, write down the times you collected the samples on the pink form that came with this paper.

10. Bring your samples, pink form and bottle (with cap) to your clinic visit.

Put the long tubes and the bottle (with cap) back in the plastic bag, and put the bag in the refrigerator. Please bring your pink sheet and bag with you to your clinic visit.

Questions? Please call your Scheduling Coordinator.

Thank you for your cooperation.