This is a case study... i need your help?
Question:
Ms . Smith complains that she is having difficulty falling asleep at night. This has been occurring more frequently over the past year. She says. "I am so tired in the mornings, I can hardly get out of bed"
1)from what sleep disorder is Ms. Smith Suffering?
2)What assessement tool might be used to determine her problem?
3)What options are available to help Ms. Smith
4)What will Ms. Smith report if the interventions are successful?
thanks a lot. i really need your answers by monday.
Answers:
Ms. Smith might be suffering from the sleep disorder (dyssomnias) Insomnia under parasomnias related to the difficulty in falling asleep. She might also be suffering from adjustment sleep disorder stemming from stress and anxiety. another disorder to consider is the circadian sleep disorder which accounts for her difficulty in awakening. Although the awakening motor problem is probably due to the lack of sleep .
A sleep diary can be used to help diagnose, and measure improvements in sleep disorders. The Epworth Sleepiness Scale is another useful diagnostic tool.
You can assess her problem by her sleepy and tired appearance. And by her main c/o i.e., difficulty in falling asleep at night.
Treatments for sleep disorders generally can be grouped into three categories: 1) behavioral/ psychotherapeutic treatments, 2) medications, and 3) other somatic treatments. None of these general approaches is sufficient for all patients with sleep disorders.
Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. In general, medications and somatic treatments provide more rapid symptomatic relief from sleep disturbances.
On the other hand, some emerging evidence suggests that treatment gains with behavioral treatment of insomnia may be more durable than those obtained with medications
Options or interventions are: Meditation techniques, yoga, stress relief, identifying any anxiety related problems; set up regular sleep schedules; avoid alcohol; soda and caffeine at night; warm bath; consuming warm decaffeinated green tea; soothing music ; read a boring book or watch TV; sex; might help.
For most sleep disorders, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can be effectively combined to maximize therapeutic benefits.
Outcomes of successful interventions: rested appearance of Ms Smith. Her verbal statements that she slept good and she feels rested. not tired from lack of sleep. That she didn't have a hard time getting out of bed.
1) Sleep apnea or possbly an axiety disorder
2) Sleep test
3) Cpap and possibly something like ambien or lunesta
4) Deeper more restful sleep.
This is a classical case of insomnia with anxiety neurosis.She would need a psychiatrists consultation to rule out any organic dis order.
ms smith needs sex, or exercise before bed to take her problems off her mind and get tired so she can sleep like a rock.
problems in her life or work can be making her unable to sleep at night because she is worried about them and tries to finds a solution.
i dont believe sleeping pills or something can make ms smith`s problem better because she will need them after a while and she will become dependant to them ...
:)
also, she should train her body and change her way of life to be able to sleep, some good tips are moving the tv to another room so her bedroom is only for sleeping and sometimes love making, that way her brain doesnt get distracted and she can sleep in her room without being tempted to stay up late watching tv or somethin
1) Ms. Smith may not have a sleep disorder. Is she drinking caffeine/coffee/caffinated tea,etc. after dinner? Late in the evening? Haveing a late sugared snack? Is she under stress? What shift does she work? Look for lifestyle issues that may alter her sleep pattern. Has she moved? rearranged her bed? Is there a light shining in her eyes,etc.
2) interview her; an observation visit may be helpful.
3) remove/ fix issue from question#1; Relaxation therapy; lavender aroma therapy;soothing music or nature sounds; and the old -- warm milk.
4) easier to doze off; more relaxed; more restful sleep; feeling refreshed and well rested in the morning; more stamina during the day; less tired; get up from bed is easier; ready to face the day,etc.
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