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    Red flags
    • 08 Dec 2023
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    Red flags

    • Updated on 08 Dec 2023
    • 1 Minute to read
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    Article summary

    The below are example red flags for insomnia. Other red flags can exist, and clinical acumen is required. If red flags are present, consider urgent referral or admission.

    For more information on red flags, see NICE CKS guidance.

    Brain tumour
    • Early morning headache or vomiting
    Metastatic disease
    • Unremitting bone pain
    • Cachectic appearance
    Psychiatric 
    • Suicidal thoughts
    • Delusions or hallucinations suggestive of psychosis
    Haematological malignancy
    • Splenomegaly 
    • Lymphadenopathy
    • Spontaneous bruising
    • Unexplained weight loss
    • Pallor
    • Persistent bone or back pain 
    • Recurrent infections
    • Unexplained pruritis 
    • Unexplained shortness of breath 
    Thyrotoxicosis
    • Malaise, fever or thyroid pain
    • Agitation, anxiety, palpitations, insomnia, heat intolerance, sweating
    • Unintentional weight loss, diarrhoea, thyroid enlargement
    References and Further Information:
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