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Common sleep-related symptoms include: Difficulty falling asleep, despite feeling physically tired Frequent nighttime awakenings, often with heightened alertness Restless or fragmented sleep, leading to non-restorative rest Vivid, intense, or emotionally charged dreams, sometimes remembered in detail Night sweats, particularly during early withdrawal Feeling wired at night but exhausted during the day, reflecting circadian disruption The brain gradually restores natural sleep regulation

However, the conservative approach is waiting until skeletal maturity and the early 20s when growth plates are fully closed and endocrine systems are mature

Patients unsuitable for HSCT and those with a very prolonged CR can be managed with repeated cycles of ATO (e.g

Pobee, E

This approach has led to one of the early programmes for inhaled insulin and eventually to FDA-approved inhaled l-DOPA for the treatment of Parkinson disease 106,107