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Direction (1 - 9): Read the passage given below carefully and answer the questions.

1. Our bodies depend on sleep to keep a number of delicately balanced systems running smoothly. Without it these systems become subtly off-key, which can eventually lead to more serious consequences. The odd broken night never hurt anyone, but some sleep experts are now saying that even just an hour of missed sleep, night after night, can cause ill health.

2. Do you ever find yourself awake in the middle of the night staring at the ceiling for hours, willing sleep to come? Do you sometimes lie in bed thinking about troubles of the past, worries of the present, or concerns for the future, all the while struggling to fall asleep? Perhaps you have difficulty staying asleep and constantly find yourself waking multiple times in the middle of the night and have trouble getting back to sleep, or you simply wake up earlier than you'd like, but find it impossible to go back to sleep.

3. If any of these examples sound like something you've experienced, chances are that you've had some form of insomnia, and depending on how often this happens to you, your restless nights could be sign of a serious sleep disorder.

4. But what causes insomnia? Persistent low-level fatigue is extremely common since one in three of us has problems dropping off or sleeping through the night. The cause can lie in surrounding factors, such as an uncomfortable mattress or noisy neighbours. Some insomnia is temporarily caused by stress brought on by a forthcoming special event, such as an exam or getting married or pressure at work. How you feel can notoriously affect sleep, too. Anxiety, anger or resentment can all stop us from dropping off to sleep and is also one of the prime causes of depression in early morning waking.

5. Sleep apnoea, a common disorder in which lapses in breathing cause a shortage of oxygen, which in turn disrupts sleep, may need treatment. Shift work, partying in the sleep hours and jet lag can also disrupt the body's internal clock that tells us when to stay awake and when to sleep (doctors call this sort of insomnia 'circadian rhythm disorder').

6. Too much food, tea, coffee, cola or other stimulants can also be culprits. Physical illness such as pain from arthritis can be a factor too, as can drugs such as those used to treat chronic illnesses like high blood pressure and asthma. Some of us simply need to make sure that the bedroom is a calm, pleasant place which is conducive to sleep. We should also avoid daytime naps. And last but not the least, anxiously lying awake worrying about not sleeping can cause what the doctors call psycho-physiological insomnia.

7. What are the 'knock-on effects' of insomnia? Whatever the cause, fatigue can have devastating effects on all aspects of our lives. It is thought to be a principle factor in around 10 per cent of the road accidents in Britain, for instance. Now research in the USA offers some clues as to the further effects of this disturbance to the body's natural rhythms. Perhaps the greatest risk could be the effect on the immune system. The research shows that loss of sleep can slow down the action of cells which are involved in fighting off infection and even protecting us against more serious diseases such as cancer.

8. People who suffer from long periods of stress, such as after bereavement, seem to be more vulnerable to illness, which suggests that lack of sleep may be a factor. Research also suggests that lack of sleep can make you want to eat too much! Although food didn't actually lift the symptoms of fatigue, it gave the illusion of staying awake.

9. How does lack of sleep affect ageing? Lack of sleep may even contribute to or speed up the ageing process. During sleep, the body produces a hormone which is vital for growth and cell renewal. Without enough sleep this rejuvenation time is lost. It comes as no surprise that the period in life when we sleep most, as babies and toddlers, is the period of greatest growth.

10. One thing is certain: sleep is important and we could do worse than add a new resolution to the rules for living a long and healthy life: don't smoke, eat plenty of fresh fruits and vegetables, exercise regularly and ....... make sure you get enough sleep!

........... is not a symptom of insomnia.

A) Waking multiple times in the night

B) Lying in bed struggling to fall asleep

C) Waking up earlier than normal, but finding it impossible to go back to sleep

D) Being more vulnerable to illness