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. Author manuscript; available in PMC: 2009 Nov 1.
Published in final edited form as: J Am Geriatr Soc. 2009 May;57(5):761–789. doi: 10.1111/j.1532-5415.2009.02220.x

Table 7. Advanced Sleep Phase Disorder (ASPD).

Recommendations for management of ASPD Quality of Evidence (with references) Strength of Evidence
1. Chronotherapy (sleep-wake scheduling) is achieved by advancing sleep and wake times until the desired sleep and wake times are achieved. This approach, although possibly useful, is often clinically impractical. III 160 C
2. Scheduled bright light in the evening delays circadian rhythms and improves sleep in patients with ASPD. II 168,193 B
3. Melatonin should not be used in older persons with ASPD. III 193 B
4. Overall, there is little scientific evidence to support the efficacy of behavioral interventions. However, because of the lack of alternative approaches and since the risks and relative costs are low, behavioral interventions are recommended. III B