Understanding Insomnia in Children and Teens: What Parents Should Know

Sleep is one of the most critical components of healthy development in children and teenagers, yet insomnia remains a widespread and often underestimated problem affecting young people worldwide. Approximately 34.5% of adolescents report insomnia symptoms, while one out of five young children and preadolescents of the general population have insomnia symptoms. For parents, understanding the complexities of pediatric insomnia—its causes, symptoms, consequences, and treatment options—is essential to supporting their children’s overall health and well-being.

What is Insomnia in Children and Teens?

Insomnia is more than just an occasional restless night. It represents a persistent sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early, despite having adequate opportunity to rest. For children and adolescents, insomnia manifests in ways that can significantly impact their mood, behavior, cognitive function, and academic performance.

For a diagnosis, these issues must occur at least 3 times per week and persist for at least 1 month for acute insomnia or 3 months for chronic insomnia. The condition goes beyond simple sleep dissatisfaction—it involves recurrent and chronic perceived sleep dissatisfaction occurring several times per week, resulting in significant distress and daytime consequences such as sleepiness, difficulties with attention, concentration and memory, and mood lability.

Unlike adults who can typically self-report their sleep difficulties, in children, insomnia is primarily identified through parental reports. This makes parental awareness and observation crucial for early detection and intervention.

The Prevalence of Pediatric Insomnia: A Growing Concern

The prevalence of insomnia varies across different age groups and populations, but the numbers are consistently concerning. In preschool children (age 4), the prevalence is estimated to be 36%, while in elementary school children (age 5–10), the prevalence is estimated to be 20%, and in adolescents (age 11–17) ranges from 4 to 23.8%.

Insomnia has been generally estimated to be a problem in about 20–25% of young people, though data from the literature indicate that insomnia during adolescence is underreported, under-diagnosed (or mis-diagnosed) and, therefore, under (or mis-) treated. This underdiagnosis represents a significant public health challenge, as many children suffer silently without receiving appropriate care.

Research also reveals important gender differences. The prevalence of insomnia symptoms was highest in girls age 11–12 (30.6%), suggesting that hormonal changes associated with the onset of puberty rather than anxiety and depression may play a role in this increased vulnerability.

Perhaps most concerning is that sleep problems are common among adolescents, and the prevalence seems to be on the rise, indicating that this is not just a static problem but one that is worsening over time.

Types and Patterns of Pediatric Insomnia

Understanding the different types of insomnia can help parents and healthcare providers identify specific issues and tailor interventions accordingly.

Behavioral Insomnia of Childhood

Behavior subtypes of childhood insomnias affect 10% to 30% of children and result from inconsistent parental limit-setting and improper sleep-onset association. This type of insomnia has three main subtypes:

Sleep-Onset Association Type: Children have difficulty initiating sleep independently and associate falling asleep with certain circumstances, such as place (couch or parent’s bed), a person’s presence (parent), or an activity (feeding from a bottle, being rocked, watching television).
Limit-Setting Type: The child delays bedtime with multiple requests or refusal, while the parent has difficulty setting limits, allowing bedtime to delay.
Mixed Type: If a child requires certain circumstances to initiate sleep and there are difficulties with parental limit-setting, the diagnosis is combined type.

Insomnia Patterns by Sleep Phase

Children may experience different patterns of sleep disruption:

Onset Insomnia: Children have a difficult time falling asleep, typically defined as taking longer than 30 minutes.
Middle Insomnia: Children will wake up in the middle of the night or are unable to sleep long periods of time.
Terminal Insomnia: Children will wake up too early in the morning.

Common Causes and Risk Factors for Insomnia in Young People

Pediatric insomnia rarely has a single cause. Etiology of pediatric insomnia is almost always multifactorial, involving a complex interplay of biological, psychological, environmental, and behavioral factors.

Biological and Developmental Factors

Puberty is associated with circadian delay, which may cause insomnia symptoms such as problems falling asleep and daytime impairments, but also difficulties rising in the morning. This biological shift in adolescent sleep patterns creates a natural tendency toward later sleep and wake times, which often conflicts with early school start times.

Adolescents with insomnia and circadian delay symptoms were often evening-types (56.9%), had long social jetlag (2:55 h) and large school-/free day discrepancy in sleep duration (6:04 vs. 8:34 h). This “social jetlag”—the difference between sleep patterns on school days versus free days—can significantly disrupt sleep quality and daytime functioning.

Psychological and Emotional Factors

Mental health plays a significant role in pediatric sleep problems. Insomnia in the general teenage population is associated with mental health difficulties later in life and increased risk of interpersonal problems and psychiatric disturbances, which may include mood and anxiety disorders, risk-taking behaviors, substance use disorders, and higher suicidal risk.

The relationship between insomnia and mental health is bidirectional. A history of insomnia did predict occurrence of depression in later life, and a prior history of anxiety disorder was associated with increased risk of insomnia. This creates a concerning cycle where sleep problems and mental health issues can perpetuate each other.

Academic and social pressures also contribute significantly. High school is a period during which students are under enormous pressure to keep up with academic situations (e.g. exams, work groups, homework), deal with parental and societal expectations, balance social life, sports, and extra-curricular activities while studying, and school pressure increases with age and is higher in girls compared to boys.

Technology and Screen Time

The pervasive use of electronic devices has emerged as a major contributor to sleep problems in children and teens. Excessive screen time before bed exposes young people to blue light, which suppresses melatonin production and delays sleep onset. Additionally, the stimulating content of games, social media, and videos can increase arousal and make it difficult for the brain to wind down for sleep.

The temptation to stay connected with friends through messaging apps and social media can lead to delayed bedtimes and interrupted sleep when notifications arrive during the night. Many teens keep their phones within arm’s reach, making it difficult to establish healthy boundaries around technology use and sleep.

Medical Conditions and Medications

Various medical conditions can interfere with sleep quality. Medical conditions like allergies, asthma, eczema, fibromyalgia, GERD, growing pains or thyroid disease, medications like corticosteroids and those that treat attention deficit disorder (ADHD), depression and convulsions, neurodevelopment disorders like Asperger’s syndrome or autism and mental disabilities, and sleep disorders like obstructive sleep apnea (OSA) and restless legs syndrome (RLS) can all contribute to insomnia.

Rheumatological conditions including juvenile idiopathic arthritis (JIA) and juvenile fibromyalgia (JF) are associated with significant sleep disruption in children and adolescents, with youth reporting poor sleep quality and daytime sleepiness.

Environmental and Lifestyle Factors

Irregular sleep schedules, particularly on weekends, can disrupt the body’s internal clock. Caffeine consumption, especially in the afternoon and evening, is another common culprit. Many teens consume energy drinks, coffee, or caffeinated sodas without realizing how these beverages can interfere with their ability to fall asleep hours later.

The sleep environment itself matters significantly. Bedrooms that are too warm, too bright, or too noisy can make it difficult for children to fall and stay asleep. Inconsistent bedtime routines or the absence of a calming pre-sleep routine can also contribute to sleep difficulties.

Recognizing the Symptoms of Insomnia in Children and Teens

Identifying insomnia in young people can be challenging because symptoms may manifest differently than in adults. Parents should watch for both nighttime and daytime indicators.

Nighttime Symptoms

Taking more than 30 minutes to fall asleep regularly
Frequent awakenings during the night
Difficulty returning to sleep after waking
Waking up much earlier than desired
Restlessness and tossing and turning
Bedtime resistance or anxiety about sleep

Daytime Symptoms

Difficulty waking up in the morning
Excessive daytime fatigue and lethargy
Irritability, mood swings, or emotional outbursts
Poor concentration and focus
Behavioral problems at school or home
Falling asleep during the day or in class
Complaints of not feeling rested despite adequate time in bed

Poor sleep quality is associated with cognitive challenges where poor sleep disrupts brain functions such as decision-making, problem-solving, and attention; behavioral struggles where children with inadequate sleep may show hyperactivity, defiance, or emotional outbursts that are often mistaken for attention-deficit/hyperactivity disorder (ADHD); and physical health risks where long-term sleep deprivation weakens immunity, increases obesity risk, and raises the chance of hypertension.

The Far-Reaching Impact of Insomnia on Child Development

The consequences of untreated insomnia extend far beyond feeling tired. Sleep plays a crucial role in virtually every aspect of child and adolescent development, and chronic sleep deprivation can have serious short-term and long-term effects.

Academic Performance and Cognitive Function

Sleep is essential for memory consolidation, learning, and cognitive processing. Children and teens with insomnia often struggle with attention, concentration, and information retention, leading to reduced academic performance. They may have difficulty completing homework, participating in class discussions, or performing well on tests.

Disrupted sleep impairs memory consolidation, emotional resilience, and even physical health. The brain uses sleep time to process and store information learned during the day, so inadequate sleep directly interferes with this critical function.

Mental Health and Emotional Well-Being

Adolescent insomnia significantly influences academic performance, life, and growth, with the effects on growth mainly manifested in physical and mental health, and can cause eating disorders, obesity, anxiety/depression, attention problems and aggressive behavior, alcohol and substance use disorders, and risk-taking behavior such as violence or suicidal ideation.

Insomnia disorder is associated with depression and other psychiatric disorders, and is an independent risk factor for suicidality and substance use in adolescents. This connection between sleep and mental health underscores the critical importance of addressing sleep problems early and comprehensively.

Physical Health Consequences

There is growing evidence of a strong association of insomnia (especially among adolescents) with biologically devastating alterations that include brain cortical misfunctioning, systemic inflammation, and metabolic changes.

The presence of insomnia was associated with an increased risk of reporting a new medical condition, highlighting how sleep problems can contribute to broader health issues. Chronic sleep deprivation has been linked to weakened immune function, increased risk of obesity, cardiovascular problems, and metabolic disorders.

Children and teens with insomnia may experience difficulty in social interactions. Fatigue and irritability can strain relationships with peers and family members. They may withdraw from social activities, have trouble regulating emotions, or display behavioral problems that affect their ability to form and maintain friendships.

Childhood sleep disorders can disrupt family dynamics and cause cognitive and behavior problems. The entire family unit can be affected when a child struggles with sleep, leading to increased stress for parents and siblings.

Long-Term Persistence and Health Risks

One of the most concerning aspects of pediatric insomnia is its tendency to persist over time. 43% of children with insomnia symptoms continued to suffer through adolescence into adulthood. This persistence means that childhood sleep problems can set the stage for lifelong health challenges.

Insomnia symptoms in childhood are much more likely to persist over time than previously believed, and parents and clinicians should not assume that insomnia symptoms are benign complaints that will go away with age. This finding emphasizes the importance of early intervention rather than adopting a “wait and see” approach.

Childhood-onset insomnia confers a greater risk for health problems because of the chronic exposure to sleeplessness, making early identification and treatment even more critical.

Disparities in Pediatric Sleep Health

Recent research has revealed concerning disparities in how insomnia affects different populations of children. Children and teens from racial and ethnic minority groups are disproportionately affected by persistent insomnia symptoms that begin in childhood and continue through young adulthood.

Those risks may be higher for Black and Hispanic/Latino children compared to non-Hispanic white children because disparities in sleep patterns begin at a young age. These disparities may be related to various factors including socioeconomic conditions, environmental stressors, access to healthcare, and systemic inequities that affect sleep quality and duration.

Understanding these disparities is essential for healthcare providers and policymakers to develop targeted interventions and ensure equitable access to sleep health resources for all children, regardless of their background.

Comprehensive Strategies to Help Children and Teens Sleep Better

Addressing pediatric insomnia requires a multifaceted approach that combines behavioral interventions, environmental modifications, and sometimes professional treatment. Parents play a crucial role in implementing these strategies and creating conditions that promote healthy sleep.

Establishing Healthy Sleep Hygiene

Sleep hygiene refers to the habits and practices that promote consistent, quality sleep. These foundational strategies should be the first line of defense against insomnia:

Consistent Sleep Schedule: Maintain regular bedtimes and wake times, even on weekends. This helps regulate the body’s internal clock and makes falling asleep easier.
Bedtime Routine: Consistent bedtime routines and sleep schedules are critical targets for parent education programs. Create a calming 30-60 minute routine before bed that might include activities like reading, gentle stretching, or listening to quiet music.
Optimal Sleep Environment: Ensure the bedroom is cool (around 65-68°F), dark, and quiet. Consider using blackout curtains, white noise machines, or fans if needed.
Comfortable Bedding: Invest in a comfortable mattress and pillows appropriate for your child’s age and size.

Managing Technology and Screen Time

Given the significant impact of technology on sleep, establishing clear boundaries is essential:

Implement a “digital curfew” at least 1-2 hours before bedtime
Remove electronic devices from the bedroom, including smartphones, tablets, computers, and televisions
Use blue light filters on devices if evening use is unavoidable
Encourage alternative relaxing activities before bed, such as reading physical books or journaling
Model healthy technology habits as parents

Dietary Considerations

What children eat and drink can significantly affect their sleep:

Education about the effects of alcohol and caffeine can improve many issues related to insomnia. Monitor and limit caffeine intake, especially in the afternoon and evening. Remember that caffeine is found not only in coffee but also in tea, chocolate, energy drinks, and many sodas.
Avoid large meals close to bedtime, but don’t let children go to bed hungry either
Consider a light, sleep-promoting snack if needed, such as a small serving of complex carbohydrates or foods containing tryptophan
Ensure adequate hydration during the day but limit fluids close to bedtime to reduce nighttime awakenings

Physical Activity and Exercise

Regular exercise improves sleep, and for some individuals, exercise 3 to 6 hours before sleep may be helpful. Encourage daily physical activity, but avoid vigorous exercise too close to bedtime as it can be stimulating. Morning or afternoon exercise is generally most beneficial for sleep.

Relaxation Techniques

Teaching children and teens relaxation strategies can help them manage anxiety and wind down for sleep:

Deep breathing exercises or diaphragmatic breathing
Progressive muscle relaxation
Guided imagery or visualization
Mindfulness meditation adapted for children
Gentle yoga or stretching
Listening to calming music or nature sounds

Addressing Behavioral Sleep Problems

Behavior insomnias are treated using extinction techniques and parent education. For younger children with behavioral insomnia, specific techniques can be effective:

Graduated Extinction: Gradually increasing the time before responding to a child’s calls or cries at bedtime
Bedtime Fading: Temporarily moving bedtime later to match the child’s natural sleep time, then gradually moving it earlier
Positive Routines: Behavioral therapies for this type of insomnia include extinction, bedtime fading with positive routines, and scheduled awakening
Consistent Limit-Setting: Establishing and maintaining clear, consistent boundaries around bedtime

It is recommended that parents put the babies to bed “drowsy but awake” to help them learn to initiate sleep independently and return to sleep without requiring intervention, the so-called self-soothing skills.

Professional Treatment Options for Pediatric Insomnia

When home-based strategies are insufficient, professional interventions may be necessary. Several evidence-based treatments are available for children and adolescents with persistent insomnia.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Insomnia and related sleep disturbances commonly affect youth, with prevalence rates estimated at ~30% in school-aged children (6–12 years) and ~24% in adolescents (13–18 years), and behavioral sleep interventions, ranging from brief educational interventions to behavioral therapies (cognitive-behavioral therapy-insomnia; CBT-I), are associated with positive outcomes for pediatric sleep health.

CBT-I is considered the gold standard treatment for insomnia in adults and has shown promising results in children and adolescents. This structured program typically includes:

Sleep education and psychoeducation about sleep processes
Stimulus control therapy to strengthen the association between bed and sleep
Sleep restriction therapy to consolidate sleep
Cognitive restructuring to address unhelpful thoughts about sleep
Relaxation training

Additionally, sleep interventions may improve psychiatric health for children and adolescents with neurodevelopmental and internalizing disorders, making CBT-I particularly valuable for children with comorbid conditions.

Cognitive behavioral therapy “refresher” sessions every 3 months to yearly will also help maintain good sleep hygiene strategies, emphasizing the importance of ongoing support.

Light Therapy for Circadian Rhythm Disorders

For adolescents whose insomnia is related to circadian rhythm delays, light therapy can be effective. In patients with circadian rhythm disorders, light therapy in the morning can help reset the suprachiasmatic nuclei, where the individual is exposed immediately upon awakening to 8,000–10,000 lux of bright light for 20 to 30 minutes.

This treatment helps shift the body’s internal clock earlier, making it easier to fall asleep at an appropriate time and wake up for school. Light therapy is most effective when combined with consistent sleep schedules and good sleep hygiene.

Pharmacological Interventions

No medications are approved by the Food and Drug Administration (FDA) for the treatment of pediatric insomnia, yet medications are sometimes used when behavioral interventions alone are insufficient. It is imperative that medication use be short term and be used in conjunction with behavioral interventions.

Melatonin: Melatonin is currently the most frequently prescribed hypnotic for pediatric patients. A consensus panel of pediatric sleep clinicians in the US has advised that 1–5 mg of melatonin taken 30–60 min before bedtime may be beneficial among youth who are refractory to behavioral interventions.

However, a 2023 meta-analysis of eight randomized, controlled trials in typically developing youth with idiopathic insomnia found only a modest decrease in sleep latency and a similarly modest increase in total sleep time, but no significant effect on sleep quality or daytime functioning was observed. Melatonin appears most effective for children with neurodevelopmental disorders and circadian rhythm issues.

Other Medications: Pharmacotherapy for insomnia in youth is generally not a permanent intervention, and for transient episodes of insomnia, melatonin or antihistamines such as diphenhydramine (Benadryl) have been used clinically with varying degrees of success. However, the evidence in support of antihistamines for pediatric insomnia is severely limited.

Hypnotic medications are not recommended for behavioral insomnia in children. Any medication use should be carefully discussed with a healthcare provider, considering the child’s specific situation, potential side effects, and the lack of long-term safety data in pediatric populations.

Treating Underlying Medical Conditions

When insomnia is secondary to another medical condition, addressing the underlying issue is essential. This might include:

Managing allergies or asthma that interfere with breathing during sleep
Treating gastroesophageal reflux disease (GERD)
Addressing pain conditions
Evaluating and treating sleep-disordered breathing or obstructive sleep apnea
Managing restless legs syndrome or periodic limb movement disorder

The diagnosis of insomnia is clinical, and polysomnography is not needed unless other sleep disorders are suspected. However, when symptoms suggest conditions like sleep apnea, a sleep study may be necessary.

When to Seek Professional Help

While many sleep problems can be addressed with behavioral strategies at home, certain situations warrant professional evaluation and treatment. Parents should consult a healthcare provider if:

Sleep problems persist for more than a few weeks despite implementing good sleep hygiene
Insomnia is severely impacting the child’s daytime functioning, academic performance, or behavior
The child shows signs of depression, anxiety, or other mental health concerns
There are symptoms suggesting sleep-disordered breathing, such as snoring, gasping, or pauses in breathing during sleep
The child experiences unusual movements or behaviors during sleep
Sleep problems are accompanied by physical health complaints
The family is experiencing significant stress related to the child’s sleep issues
Previous attempts at behavioral interventions have been unsuccessful

Anticipatory guidance at well child appointments by primary care providers is the most important preventative measure against developing common sleep disorders, and good sleep habits are correlated with better behavioral health outcomes. Regular discussions about sleep during pediatric check-ups can help identify problems early.

Early recognition and management can prevent these complications associated with chronic sleep problems. Don’t hesitate to raise sleep concerns with your child’s pediatrician, even if they seem minor.

Special Considerations for Different Age Groups

Infants and Toddlers

For the youngest children, sleep problems often center around sleep associations and night wakings. In infants and young children, bedtime problems and night waking are common and the main presentations of insomnia, and poor sleep may critically impact the daytime functioning and mood of the child and their caregivers.

Parent education about their child’s sleep, bedtime routines, and sleep hygiene is essential for treatment. Teaching parents about normal infant sleep patterns and developmentally appropriate expectations can prevent unnecessary interventions and reduce parental anxiety.

School-Age Children

As children enter school, sleep needs remain high (9-12 hours per night), but new challenges emerge. Academic demands, extracurricular activities, and social pressures can all impact sleep. This age group benefits particularly from:

Consistent routines that balance activities with adequate sleep time
Clear boundaries around technology use
Strategies to manage school-related stress and anxiety
Education about the importance of sleep for learning and performance

Adolescents

Teenagers face unique sleep challenges due to biological changes, social pressures, and often early school start times. Insomnia in adolescence is common, particularly in older adolescents and in girls, with a prevalence that is comparable of that of other major psychiatric disorders, and insomnia tends to be chronic with 88% of adolescents with a history of insomnia reporting current insomnia.

Interventions for teens should:

Acknowledge and work with their natural circadian shift toward later sleep times
Address the role of technology and social media
Involve the teen in developing solutions and taking ownership of their sleep health
Consider the impact of part-time jobs, homework load, and extracurricular commitments
Address mental health concerns that may be contributing to sleep problems

The Role of Schools and Communities

Addressing pediatric insomnia requires efforts beyond the home and healthcare system. Schools and communities play important roles in supporting healthy sleep for young people.

School Start Times

Research consistently shows that early school start times conflict with adolescent biology and contribute to chronic sleep deprivation. Many medical and educational organizations recommend that middle and high schools start no earlier than 8:30 AM to allow teens to get adequate sleep. Communities that have implemented later start times have seen improvements in student attendance, academic performance, mental health, and even reduced car accidents among teen drivers.

Sleep Education

Incorporating sleep education into school curricula can help students understand the importance of sleep and develop healthy habits. Topics might include:

The science of sleep and circadian rhythms
How sleep affects learning, memory, and performance
Practical strategies for improving sleep
The impact of technology on sleep
Recognizing and addressing sleep problems

Homework and Activity Policies

Schools can support student sleep by implementing reasonable homework policies that allow time for adequate rest, being mindful of the cumulative burden of assignments across multiple classes, and scheduling extracurricular activities at times that don’t excessively interfere with sleep.

Creating a Family Culture That Values Sleep

Perhaps the most powerful thing parents can do is create a family culture that prioritizes and values sleep. This means:

Modeling healthy sleep habits: Children learn by example. When parents prioritize their own sleep and maintain consistent routines, children are more likely to do the same.
Making sleep a family priority: Treat sleep as non-negotiable, just like nutrition and safety. Avoid scheduling activities that consistently interfere with adequate sleep time.
Having open conversations: Talk with children about sleep, listen to their concerns, and involve them in problem-solving when sleep issues arise.
Being patient and consistent: Changing sleep patterns takes time. Stick with new routines and strategies even when progress seems slow.
Celebrating successes: Acknowledge and praise improvements in sleep habits and recognize the positive effects of better sleep on mood, energy, and performance.

Looking Forward: The Importance of Early Intervention

The research is clear: pediatric insomnia is not something children simply “grow out of.” Most people assume that difficulty falling asleep and staying asleep is a phase that kids will outgrow, but insomnia isn’t like childhood sleep terrors or sleepwalking—it won’t go away with puberty and maturation for many children.

Insomnia symptoms in adolescents who slept short in the lab were 5.5 times more likely to worsen into adult insomnia, and those with insomnia symptoms and laboratory-measured short sleep duration are much more likely to evolve to develop a clinical condition in early adulthood. This underscores the critical importance of addressing sleep problems early and comprehensively.

By understanding the causes, recognizing the symptoms, and implementing evidence-based strategies, parents can help their children develop healthy sleep patterns that will serve them throughout their lives. Whether through behavioral interventions at home, professional treatment when needed, or systemic changes in schools and communities, addressing pediatric insomnia is an investment in children’s immediate well-being and long-term health.

Conclusion: Empowering Parents to Support Healthy Sleep

Understanding insomnia in children and teens is essential for parents who want to support their children’s health, development, and overall quality of life. Sleep is not a luxury—it’s a biological necessity that affects every aspect of a young person’s physical, mental, and emotional well-being.

The good news is that pediatric insomnia is treatable. With the right combination of behavioral strategies, environmental modifications, professional support when needed, and a family culture that values sleep, most children can overcome sleep difficulties and establish healthy patterns that will benefit them for years to come.

As parents, your role is crucial. By educating yourself about sleep, implementing evidence-based strategies, modeling healthy habits, and seeking help when needed, you can make a profound difference in your child’s sleep health. Remember that every child is unique, and what works for one may not work for another. Be patient, stay consistent, and don’t hesitate to reach out to healthcare professionals for guidance.

For more information on pediatric sleep health, visit the American Academy of Sleep Medicine or the Sleep Foundation. Additional resources on child development and health can be found at the American Academy of Pediatrics. If you’re concerned about your child’s sleep, the Centers for Disease Control and Prevention offers helpful guidelines on recommended sleep durations for different age groups.

By taking action now to address sleep problems, you’re not just helping your child get through the night—you’re setting the foundation for a lifetime of better health, improved academic and social success, and enhanced quality of life. Sleep matters, and with your support, your child can achieve the restorative rest they need to thrive.

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