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 confi dence) 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 fi rst-tier degree of confi dence, respectively. No recommendations were provided for remaining treatments/ populations, due to either insuffi cient or absent data. Areas where further research is needed are discussed.
- Circadian rhythms
ASJC Scopus subject areas
- Clinical Neurology
- Pulmonary and Respiratory Medicine