Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015

Sep 29, 2015Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

Guidelines for Treating Natural Sleep-Wake Cycle Disorders: Early, Delayed, Non-24-Hour, and Irregular Sleep Patterns

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Abstract

Strategically timed melatonin is positively endorsed for treating intrinsic circadian rhythm sleep-wake disorders in select populations.

  • Melatonin is recommended for adults with delayed sleep-wake phase disorder (DSWPD), blind adults with non-24-hour sleep-wake disorder (N24SWD), and children/adolescents with irregular sleep-wake rhythm disorder (ISWRD) and neurological comorbidities.
  • Light therapy, with or without behavioral interventions, is suggested for adults with advanced sleep-wake phase disorder (ASWPD), children/adolescents with DSWPD, and elderly individuals with dementia.
  • Recommendations against melatonin use are made for elderly patients with dementia, supported by a first-tier degree of confidence.
  • No recommendations were given for other treatments due to insufficient or absent data, highlighting gaps in current research.

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