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* 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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