Journal
JOURNAL OF CLINICAL SLEEP MEDICINE
Volume 11, Issue 10, Pages 1199-1236Publisher
AMER ACAD SLEEP MEDICINE
DOI: 10.5664/jcsm.5100
Keywords
circadian rhythms; DSWPD; ASWPD; N24SWD; ISWRD
Categories
Funding
- American Academy of Sleep Medicine
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A systematic literature review and meta-analyses (where appropriate) were performed and the GRADE approach was used to update the previous American Academy of Sleep Medicine Practice Parameters on the treatment of intrinsic circadian rhythm sleep-wake disorders. Available data allowed for positive endorsement (at a second-tier degree of confidence) of strategically timed melatonin (for the treatment of DSWPD, blind adults with N24SWD, and children/adolescents with ISWRD and comorbid neurological disorders), and light therapy with or without accompanying behavioral interventions (adults with ASWPD, children/adolescents with DSWPD, and elderly with dementia). Recommendations against the use of melatonin and discrete sleep-promoting medications are provided for demented elderly patients, at a second-and first-tier degree of confidence, respectively. No recommendations were provided for remaining treatments/populations, due to either insufficient or absent data. Areas where further research is needed are discussed.
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