Sleep medicine
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Missing data, e.g. patient attrition, are endemic in sleep disorder clinical trials. Common approaches for dealing with this situation include complete-case analysis (CCA) and last observation carried forward (LOCF). Although these methods are simple to implement, they are deeply flawed in that they may introduce bias and underestimate uncertainty, leading to erroneous conclusions. ⋯ These principled strategies are compared with "complete-case analysis" and LOCF. These analyses illustrate that methodologies for accommodating missing data can produce different results in both direction and strength of treatment effects. Our goal is for this paper to serve as a guide to sleep disorder clinical trial researchers on how to utilize principled methods for incomplete data in their trial analyses.
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To examine the psychometric properties of the Spanish version of the Insomnia Severity Index (ISI) and to determine its factor structure with confirmatory factor analysis (CFA). ⋯ The ISI is a reliable and valid instrument to assess the subjective severity of insomnia in Spanish-speaking populations. Its three-factor structure (i.e., night-time sleep difficulties, sleep dissatisfaction and daytime impact of insomnia) makes it a psychometrically robust and clinically useful measure.
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Continuous positive airway pressure (CPAP) treatment is often prescribed for youth as a treatment for obstructive sleep apnoea (OSA). Efficacy research in youth is limited, though some evidence suggests that it may relieve symptoms of OSA and possibly prevent future physical, emotional, and behavioural complications. However, the device must be used consistently for benefits to be realised. Non-adherence to medical treatment is prevalent among youth with chronic illness, yet little is known regarding adherence to CPAP in paediatric OSA. ⋯ The adherence barriers to CPAP questionnaire has the potential to be a useful clinic-based tool for identifying patient-specific issues with CPAP adherence in youth with OSA.