Assessing and Treating Patients with Sleep/Wake Disorders
Insomnia is a condition epitomized by dissatisfaction with quantity and quality of sleep-
related to trouble falling asleep, recurrent awakening during the night with trouble returning to
sleeping or awakening in the morning as desired. As well, insomnia is epitomized by momentous
impairment or distress in functioning during the day related to fatigue, impaired cognitive
performance, mood disturbance, and sleepiness during the day (
Levenson, Kay & Buysse, 2015).
The condition varies from sleep deprivation to trouble sleeping in spite of having sufficient time
to sleep. The prevalence of insomnia is approximately from 30% to 43% in people presenting a
minimum of one insomnia symptom, while the prevalence of insomnia disorder varies from 5%
to 15% (
Levenson, Kay & Buysse, 2015). The paper below seeks to explore a case study of a 31-
year-old patient with a chief complaint of insomnia and make three decisions related to
medication to prescribe to this patient.
Case Summary
The patient is a 31-year-old male who visited the clinic with complaints of insomnia that
has worsened for the last six months. The patient reported he has trouble both falling and
returning to sleep at night which started six months after the sudden loss of his fiancée. He
further reported his condition has affected his ability to perform as a forklift operator since he
sleeps on the job due to lack of sleep at night. The patient's medication history involves
diphenhydramine to help him sleep although he did not like how he felt the morning after. As
well, he has a history of opiate abuse after breaking his leg and was prescribed hydrocodone
(acetaminophen) for pain management for four years. The patient stated he has been using
alcohol for approximately four beers to be able to sleep. On mental health exam, the patient is
alert, oriented to person, place, and time, make eye contact, dressed appropriately according to

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