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Insomnia often begins as a temporary disruption but can evolve into a self-perpetuating, chronic condition with cortical overactivation, limbic dysregulation, and hypothalamic-pituitary-adrenal (HPA) axis hypersensitivity

The lower their absolute risk, the harder that case becomes

Such directional consistency suggests a potential benefit that cannot be ruled out but likely requires better-designed, adequately powered randomized trials with standardized exposure and clinical endpoints

This cyclical approach supports sustainable long-term research programs

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