title: 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: An American Academy of Sleep Medicine Clinical Practice Guideline.
abstract: 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.
authors.affiliation: Mayo Center for Sleep Medicine, Rochester, MN.
authors.forename: R Robert
authors.initials: RR
authors.lastname: Auger
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Burgess
authors.affiliation: Portland VA Medical Center, Portland, OR.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Emens
authors.affiliation: American Academy of Sleep Medicine, Darien, IL.
authors.forename: Ludmila V
authors.initials: LV
authors.lastname: Deriy
authors.affiliation: American Academy of Sleep Medicine, Darien, IL.
authors.forename: Sherene M
authors.initials: SM
authors.lastname: Thomas
authors.affiliation: Brown University, Providence, RI.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Sharkey
mesh_terms: D000047:Academies and Institutes; D000293:Adolescent; D000328:Adult; D002648:Child; D006801:Humans; D020178:Sleep Disorders, Circadian Rhythm / Q000628:therapy; D056508:Sleep Medicine Specialty; D012893:Sleep Wake Disorders / Q000628:therapy*; D014481:United States
keywords: ASWPD; DSWPD; ISWRD; N24SWD; circadian rhythms