In the first sentence of the passage, the word 'debt' is quoted because
it has been used for a special effect
it has been used in the first sentence
of the seriousness of the matter it addresses
it is capable of destroying people
Explanation
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The correct answer is A. it has been used for a special effect.
In English, we often put a word in quotation marks when we are using it metaphorically or in a non-literal way.
Why A is the correct choice:
Literal vs. Figurative: Usually, "debt" refers to money owed to a bank or a person. However, the author is using it to describe a lack of sleep. By putting it in quotes, the author signals that they are borrowing a financial term to create a "special effect"—specifically, the idea that when you don't sleep, you are "borrowing" time from your body that you will eventually have to "pay back" with your health.
The "Sleep Debt" Concept: It emphasizes that, like financial debt, sleep deprivation accumulates and carries heavy "interest" (health problems).

