Pharmacological and non-pharmacological interventions for managing sleep disorders in children with cerebral palsy: A systematic review
Abstract
AIM
To systematically review the effectiveness, safety, and economic evidence of pharmacological and non-pharmacological interventions for sleep disorders in children with cerebral palsy (CP).
METHOD
Databases including MEDLINE, Embase, CENTRAL (the Cochrane Library), International Clinical Trials Registry Platform of the World Health Organization, NHS Economic Evaluation Database, and ClinicalTrials.gov were searched up to May 2026. Randomized controlled trials and economic evaluations were eligible. Primary outcomes included sleep quality, adverse events, and tolerability. We incorporated interest holder perspectives, including clinicians and individuals with lived experience, throughout outcome prioritization and interpretation. We assessed risk of bias using the Cochrane Risk of Bias 2.0 tool and evaluated the certainty of evidence using Grades of Recommendation, Assessment, Development and Evaluation.
RESULTS
Twelve randomized controlled trials (n = 19-142, aged 5-17 years) were included. Pharmacological (melatonin, cannabis-based medicines, baclofen, neural stem cells) and non-pharmacological interventions (massage, cranial osteopathy, music therapy, acupuncture, postural support) were evaluated. Melatonin improved sleep latency and duration modestly compared with placebo. Other interventions showed inconsistent or negligible effects. Adverse events were mild and tolerability acceptable. No completed economic evaluations were identified. Interest holders highlighted…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 19 participants or records.
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