Therapy for Patients with Sleep/Wake Disorders
Insomnia is characterized as a report of difficulty falling or staying asleep that causes
severe distress and impairs daytime function despite sufficient sleep opportunities. It is a common
disorder that causes significant impairment in function and quality of life and mental and physical
morbidity and injuries (Krystal, Prather, & Ashbrook, 2019). As a result, it is essential to have
adequate care in clinical practice. This paper aims to use a case study to evaluate treatments for
patients with sleep/wake disorders.
The patient is a 31-year-old male who reports insomnia that has gotten progressively worse
over the past six months. The patient states he has never been a great sleeper but is now having
difficulty falling asleep and staying asleep at night. The problem began approximately six months
ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his
job as a forklift operator. The patient states he has used diphenhydramine in the past to sleep but
does not like how it makes him feel the morning after. He says he has fallen asleep on the job due
to a lack of sleep from the night before. The patient does have a history of opiate abuse. However,
he has not received a prescription for an opiate analgesic in 4 years. The patient states recently, he
has been using alcohol to help him fall asleep, drinking four beers before bed. The patient is alert
and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately
for the time of year. He denies auditory and visual hallucinations. His Judgement, insight, and
reality contact are all intact. The patient denies suicidal and homicidal ideation and is future-
Decision Point One

Zolpidem: 10 mg daily at bedtime

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