DIʘS — Circadian Digital Twin

Patient: M.H. · GP: Dr J. Patel · NHS Greater Manchester ICB · 03 Jun 2026

Layer 3 — TipTraQ · PranaQ · Last sync: 03 Jun 2026 07:52Proxy pipeline active

42/100

Circadian alignment

38/100

Recovery readiness

Late chronotype · DLMO 23:05 (proxy)

L1 — Vaya

Camera · conversation · melanopic proxy

Not connected

L2 — Gominak panel

D3 · B12 · ferritin · PTH blood assay

Not connected

L3 — TipTraQ

PPG · HRV · sleep staging · autonomic balance

Active · synced 07:52

Tile 1 — Circadian phase

23:05proxy

Internal night begins ~23:00. Population median 21:00–22:00. Patient is ~ 90 min delayed.

Source:TipTraQ PPG · HRV inflection · Solar zenith · Fitzpatrick correction

Tile 2 — Light exposure

32/ 100proxy

Morning: Low · Evening: High

Evening light suppressing melatonin onset. Primary upstream zeitgeber misaligned.

Source:TipTraQ sleep architecture · REM suppression · Autonomic wake signal

Tile 3 — Chronotype pattern

Delayed sleep phase

Sleep onset: 03:09 · Wake: 07:45 · Efficiency: 66%

78% of ADHD patients share this phenotype (DLMO delay ≥45 min). Non-dipping hypertension risk elevated.

Source:TipTraQ sleep staging · DLMO proxy anchor

Late DLMO + evening light overload + SNS dominance = non-dipping pattern. Bedtime antihypertensive dosing indicated per Hygia protocol. Current morning ramipril timing suboptimal for this phenotype.

Chronotherapy recommendations — for GP review

Derived from:Proxy DLMO 23:05 · mLux 32/100 · SNS load 83% · TipTraQ Layer 3

Ramipril 5 mg

Current: Morning · Evidence: Bedtime

Retiming indicated

Atorvastatin 20 mg

Current: Morning · Evidence: Evening

Retiming indicated

Omeprazole 20 mg

Current: As needed · Evidence: 30 min before breakfast

Timing to confirm

Melatonin 2 mg MR

Current: Fixed 22:00 · Evidence: DLMO-adjusted 21:00

Phase mismatch

Tile 4 — Sleep summary

Total sleep: 3h 27m
Time in bed: 5h 38m
Efficiency: 66%
Sleep start: 03:09
Sleep end: 07:45

Source:TipTraQ PPG · accelerometry · sleep staging algorithm

Tile 5 — Breathing

AHI: 4.6Normal
SpO₂: 94–98%
Snoring: 31 min

Source:TipTraQ PPG · respiratory rate variability

Tile 6 — Autonomic balance

83%

SNS

17%

PNS

High nocturnal sympathetic load — consistent with non-dipping BP pattern. Supports bedtime antihypertensive protocol.

Source:TipTraQ HRV · LF/HF ratio · nocturnal sympathovagal balance

Evidence grounding

Hygia trial n=19,084 · 45% ↓ CV events bedtime dosing
TIME Chronotype n=21,104 · chronotype-matched dosing
Lévi et al. · 500 meds ± 5× timing sensitivity
Munro 2026 · DIʘS Evidence Report 001

TipTraQ proxy pipeline · PPG → HRV → DLMO/mLux inference · PranaQ · validation pending