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For those with both anxiety-driven sleep onset difficulty and poor sleep depth, these two mechanisms are genuinely complementary and non-overlapping

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This includes cleavage of the E-peptide by intracellular proteases of the pro-protein convertase family to release mature IGF-I for secretion 20 , maintenance of pro-IGF-I to be secreted without cleavage 21–24 , or N-glycosylation in the E-peptide of the predominant IGF-I isoform (IGF-IA) 25 , and then secretion