Biological - NIH Office of Science Education - National Institutes of ...

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.
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