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Volume 32, No. 9 October 2001 @
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Factors that contribute to insomnia

* Medical illness. Head injuries, hyperthyroidism, asthma, hypertension, coronary artery disease, arthritis, fibromyalgia, headache and low back pain, seizures, Parkinson's disease and Alzheimer's disease, kidney disease and thyroid dysfunction, among others.

* Psychiatric illness. Major depression, generalized anxiety disorder, post-traumatic stress disorder, bipolar disorder, dementia and schizophrenia, among others.

* Medication and drugs. Alcohol, narcotics, amphetamines, caffeine, Reserpine, Clonodine, certain antidepressants, steroids, L-dopa, Theophylline, nicotine and others. Withdrawal from benzodiazapines, barbituates and alcohol can also be factors.

* Other sleep disorders. Sleep apnea, nocturnal myoclonus, periodic leg movements in sleep, phase advance sleep disorder, phase delay sleep disorder, sleep state misperception and nightmares.

* Poor sleep habits. Extended time in bed, napping or an irregular sleep schedule.

* Situational factors. Stress, bereavement, unfamiliar sleep environment, jet lag, shift work, bed partner or a poor sleeping environment (noise, temperature, light or a poor sleeping surface).

Source: Perlis, M.L. & Youngstedt, S.D. "The diagnosis of primary insomnia and treatment alternatives."Comprehensive Therapy, Vol. 26, No. 4.

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