Genetically predisposed individuals are susceptible to precipitating factors, contributing to the development of parasomnias. Precipitating factors include insufficient sleep and disorders causing partial awakenings from sleep. OSA is a common trigger for parasomnias, and a review of studies showed that more than one-half of children referred for sleep terrors or sleepwalking also had OSA. 21 Other triggers may include periodic limb movement disorder, gastroesophageal reflux disease, forced awakenings, and certain medications. 12 , 21
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In January 2004, Major League Baseball announced a new drug policy which originally included random, offseason testing and 10-day suspensions for first-time offenders, 30-days for second-time offenders, 60-days for third-time offenders, and one year for fourth-time offenders, all without pay, in an effort to curtail performance-enhancing drug use (PED) in professional baseball. This policy strengthened baseball's pre-existing ban on controlled substances , including steroids, which has been in effect since 1991.  The policy was to be reviewed in 2008, but under pressure from the . Congress , on November 15, 2005, players and owners agreed to tougher penalties; a 50-game suspension for a first offense, a 100-game suspension for a second, and a lifetime ban for a third.