Sleep medicine
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Randomized Controlled Trial
Beneficial effect of donepezil on obstructive sleep apnea: a double-blind, placebo-controlled clinical trial.
Previous publications have shown beneficial effects of cholinergic medication on obstructive sleep apnea (OSA) in Alzheimer's disease (AD) patients. We hypothesized that cholinergic medication could also improve OSA in non-AD patients. The present study evaluated the effects of donepezil on OSA in non-AD patients. ⋯ Donepezil treatment improved obstructive sleep apnea index, oxygen saturation, and sleepiness in parallel with a reduction in sleep efficiency. Our findings support the concept that cholinergic transmission may influence breathing regulation in OSA patients.
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To examine the quantity and quality of insomnia symptoms as predictors of treatment for depression in the largest cohort study to date. ⋯ These data suggest an association between insomnia symptoms and moderately increased risk of clinically significant depression outcomes. Insomnia should be considered as a component in prediction models for new-onset depression.
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Letter Case Reports
Post H1N1 vaccination narcolepsy-cataplexy with decreased CSF beta-amyloid.
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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.