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    1. ‘A primary limitation of the present study is its cross-sectional study design, which precludes conclusions about causality and reciprocal effects.’

      Not enough not being able to sleep isn’t great for avoiding problematic thoughts either.

      A common issue with not being able to sleep is blaming oneself for it as well.   Studies like this sometimes don’t help if they’re not taken in context, as they tend to focus on directionality and by definition are not trying to measure other factors like age or chronic pain.

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