German 2008.

Methods	Open‐label RCT. Cross‐over design. Location: single tertiary centre in Israel. Duration: 4 weeks ‐ 2 weeks for each treatment schedule; washout period was not stated in the paper.
Participants	15 participants recruited. Age, mean (range): 10 (7.5 ‐ 14.5) years Gender split: 9 males, 6 females. Diagnosis: classical CAH due to 21‐hydroxylase deficiency (n = 14), 11‐hydroxylase deficiency (n = 1).
Interventions	Participants were randomised into 2 groups for their initial treatment schedule of 3 daily doses standardized to 0700 – 0800 h, 1300 – 1400 h and 2100 – 2200 h according to participants' age. Total HC dose ranged from 13.5 mg/m²/day to 15.5 mg/m²/day. Intervention 1: a high‐morning dose, when 50% of the daily HC was taken in the morning and 25% of the daily dose at other time‐points. Intervention 2: a high‐evening dose, when 50% was taken at bedtime and 25% of the daily dose at other time‐points.
Outcomes	0800 h 17 OHP, testosterone, androstenedione, and DHEAS on the last day of each treatment; arousal number, total sleep time, sleep efficiency, and sleep latency.
Notes	Outcomes measured but not presented in the review: arousal number, total sleep time, sleep efficiency and sleep latency.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Participants were randomised to treatment, but paper does not state how sequence was generated.
Allocation concealment (selection bias)	Unclear risk	No mention of allocation of concealment.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	No mention of blinding of participants and personnel.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No mention of blinding of outcome assessments.
Incomplete outcome data (attrition bias) All outcomes	High risk	Attrition rate was not reported.
Selective reporting (reporting bias)	High risk	We did not have any access to the original trial protocols to definitely confirm this and we attempted to contact the investigators but have not received a response. Not all outcome measures listed in the 'methods' section of the paper were fully reported in the results.
Other bias	Unclear risk	We did not have any access to the original trial protocols to definitely confirm this but there was no washout period described in the paper for this cross‐over trial.