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  • rimary insomnia causes no substantial impairment of function.1,11 For example, patients with insomnia may have no demonstrable loss of daytime alertness.1,40 Less than 25% of patients referred for insomnia have primary insomnia as a first diagnosis.41 Although there may be risks in depression, anxiety, heart disease, cancer, lack of exercise, sleep apnea, and other conditions in which insomnia is
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