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Key aspects of case studies and answers to discussion questions CASE HISTORY 1: Key aspects Diagnosis Matching symptoms From Primary Information • Excessive daytime sleepiness • Possible genetic connection through mother • Vivid dreams • Inability to move after waking in the morning • Weakness associated with emotion Narcolepsy • Excessive daytime sleepiness • Cataplexy • Sleep paralysis After reading Secondary Information Is your initial diagnosis confirmed? If no, what is your new diagnosis? If no, what caused you to change your mind? Recommended treatment Expected outcome (effect of treatment on patient symptoms) Answers will vary. Answers will vary. Entering REM sleep early is consistent with vivid dreams and hypnagogic hallucinations characteristic of narcolepsy. Medication and lifestyle changes such as frequent napping Control of most symptoms ANSWERS TO DISCUSSION QUESTIONS 1. Why is it important to consider that the patient’s mother reportedly had a similar problem? It establishes the possibility of a genetic link for the patient’s disorder. Genetics is implicated in some sleep disorders and not others. In fact, a gene responsible for narcolepsy in dogs has been discovered. 2. Of what significance is it that this patient’s sleepiness began during her teen years? The excessive sleepiness characteristic of narcolepsy usually begins during a person’s teen years or early twenties. 109 Student Lesson 4
Sleep, Sleep Disorders, and Biological Rhythms CASE HISTORY 2: 3. Is it important that this patient experienced feeling weak when laughing or being tickled? Yes, it is. About 60 percent of those with narcolepsy experience this sudden, brief loss of muscle tone, often following an emotional stimulus. Key aspects Diagnosis Matching symptoms From Primary Information • Excessive daytime sleepiness • Snoring • Regular breathing (rules out OSA) Insomnia • Excessive daytime sleepiness • Snoring Is your initial diagnosis confirmed? If no, what is your new diagnosis? If no, what caused you to change your mind? Recommended treatment Expected outcome (effect of treatment on patient symptoms) After reading Secondary Information Answers will vary. Answers will vary. Excessive caffeine consumption, drinking alcohol before bedtime, and awakening during the night are all consistent with insomnia. • Improved sleep hygiene, especially reducing consumption of caffeine and alcohol • Medication if necessary Improved sleep ANSWERS TO DISCUSSION QUESTIONS 1. Why is it important that the patient’s wife confirms that although he snores, his breathing is normal during sleep? These observations help rule out obstructive sleep apnea (OSA) as the patient’s disorder. 2. The wife never witnessed any unusual events while the patient was asleep. What “unusual events” might she have noticed? She might have noticed his sleepwalking, talking in his sleep, excessive body movements, or agitation. 110
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Sleep, Sleep Disorders, and Biologi
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BSCS Development Team Rodger Bybee,
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3.5 Biological clock . . . . . . .
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About the National Institutes of He
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Introduction to Sleep, Sleep Disord
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Implementing the Module The six les
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Content Standards: Grades 9-12 Stan
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Teaching Standards The suggested te
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shot” of what the students unders
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What the Students Do Stage Engage E
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Using the Student LessonsL The hear
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Using the Web Site The Sleep, Sleep
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Glossary amplitude: Magnitude, grea
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References 1. Aserinsky, E. 1999. E
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Sleep Diary Pre-lesson Activity Eng
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tions, medications, or drugs affect
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Pre-lesson Organizer Pre-lesson Act
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Recording Bedtimes and Wake Times I
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