What causes insomnia?
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3 Answers
Stress and hyperarousal, irregular schedules, caffeine and alcohol, screens and light exposure, pain, sleep apnoea, restless legs, depression and anxiety, certain medications, and — critically — anxiety about sleep itself, which perpetuates the cycle.
Sleep-maintenance insomnia often has a different cause profile from difficulty falling asleep — alcohol, sleep apnoea, reflux, nocturia and depression feature prominently.
The most effective treatment is CBT-I, which outperforms sleeping tablets long-term and does not carry dependence risk.
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