首页> 外文期刊>Journal of clinical sleep medicine: JCSM : official publication of the American Academy of Sleep Medicine >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
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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

机译:治疗内在昼夜节律性睡眠-觉醒障碍的临床实践指南:晚期睡眠-觉醒相位障碍(ASWPD),延迟性睡眠-觉醒相位障碍(DSWPD),非24小时睡眠-觉醒节奏障碍(N24SWD)和不规则的睡眠-苏醒节律障碍(ISWRD)。 2015年更新

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摘要

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.
机译:进行了系统的文献综述和荟萃分析(在适当的情况下),并且使用GRADE方法更新了先前的美国睡眠医学学会关于内在的昼夜节律性睡眠-唤醒障碍的治疗参数。现有数据可对策略性定时褪黑素(用于治疗DSWPD,患有N24SWD的失明成年人以及患有ISWRD和合并症的神经系统疾病的儿童/青少年)进行正面认可(在第二层置信度),以及有或没有光疗法伴随的行为干预(成人ASWPD,儿童/青少年DSWPD和老年痴呆症)。针对痴呆的老年患者,建议分别以二线和一线信任度反对使用褪黑激素和促进睡眠的离散药物。由于数据不足或不存在,未对剩余的治疗/人群提供任何建议。讨论了需要进一步研究的领域。

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