Mrs. D is a 45 year old woman who sought care for chronic insomnia of 15 months

Question

Mrs. D is a 45 year old woman who sought care for chronic insomnia of 15 months duration. She stated, “I wake up 15-20 times a night and rarely sleep more than 4 hours.” Various hypnotics have been unsuccessful in relieving her symptoms.

Her history showed that about 18 months earlier, some important stressful life changes occurred. Her only child, a daughter, left for an out-of –state university. A lifelong friend and confidante moved to another community. Her husband, a successful dentist, had become more involved in various men’s organizations than he had been in the past.

A sedating antidepressant was prescribed and a second appointment was made for 1 month later. At the second appointment, which lasted 1 hour, she said “My sleep patterns have improved.” She was able to articulate that she felt unneeded, incompetent and old. As a caregiver, how would you assess Mrs. D?

Explanation / Answer

Insomnia reveals that the lady is suffering from sleep disorder. Sleeping pills should be administered to the patient, with immediate effect. Initially mild drugs should be used. Benzodiazepines,melatonin receptor stimulator, and antionvulsants are some of the categories of drugs used in these cases.

Her mental state, ie. she felt unneeded, incompetent and old, tells that the disorders are arising as a result of loss of care. This patient needs lot of care. She should be sent to a rehabilitation centre, where she doesn't feel lonely and finds some company to meet her solitude with. There only she can indulge herself in some hobby activities.

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