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Insomnia's Case Summary

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The 40-year-old female present in the office with a complaint of inability to sleep. She has well-controlled hypertension and hyperlipidemia with Lipitor and Diovan as medications. She denies additional medical problems and reports general good health. She reports that she has not been able to sleep more than three hours per night and it is starting to affect her concertation. She denies a history of psychiatric issues and reports she does not drink, smoke or do drugs. She reports not increase in stress or emotional concerns which would explain her sleeping issues. Insomnia is a common disruption in normal sleep patterns that effects 30 to 35% of people but only 10% experience long-term insomnia (Buttaro, Trybulski, Bailey & Sandberg-Cook, …show more content…

This would include going to bed at the same time nightly (Centers for Disease Control, 2017). They should ensure they sleep in a quiet, dark room, which is environmentally comfortable (Centers for Disease Control, 2017). Avoid large meals several hours before bed and have a sleep routine to promote relaxation (Centers for Disease Control, 2017). Additionally, all electronic devises and distractions should be kept out of the room, use the bedroom for sleeping (Centers for Disease Control, 2017). The patient should be educated on a reduction of stress and not to focus and dwell on insomnia, which will only make the problem worse. Pharmaceutically a patient may start with Melatonin which can detect which is a hormone produced by the Pineal gland that can be active on the GABA-nergic mechanism that induces sleep similar to benzodiazepine receptor agonist such as alprazolam (Woo & Robinson, 2016). The patient should follow up in one week or sooner if there is no improvement with the Melatonin, to escalate to a sedative. The effect of alprazolam is inhibiting GABA which has reduction in neurotransmission which decreases anxiety and enhances sleep (Woo & Robinson,

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