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

3. How would you suggest that this patient improve his sleep hygiene?
A number of improvements can be made, including maintaining a
regular sleep/wake schedule that allows for adequate sleep, avoiding
caffeine after the early afternoon, avoiding alcohol before bedtime,
unwinding before bedtime and leaving the day’s troubles behind, and
ensuring a good sleep environment.
CASE HISTORY 3:
Key aspects
Diagnosis
Matching symptoms
From Primary Information
• Patient in generally good health
• Sleepwalking as a child
• Vivid dreams that are acted out
• Sleep-related behaviors acted out late in the
sleep period
• Patient relatively young and female
• No other apparent sleep disorders present
Parasomnia (REM motor behavior disorder)
• Movement to another location (is excessive for
REM motor behavior disorder)
• Acting out vivid dreams
• Behavior occurs later in sleep period
• The patient presents symptoms that do not indicate
a clear diagnosis. Both sleepwalking and
REM motor behavior disorder are possibilities.
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.
Secondary information is consistent with diagnosis
of REM motor behavior disorder.
• Improved sleep hygiene, getting enough sleep,
maximize safety of sleeping environment, and
consult a specialist for an evaluation
• Possibly medication
Reduced frequency of parasomnia episodes
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Student Lesson 4