Posted by Ashish Shah on March 08, 2003 at 11:39:08:In Reply to: Case posted by Strohl on March 04, 2003 at 18:36:12:
FOR RLS: uncomfortable feeling inherlegs, need to get up and wlak around. Complaints of fatigue. Presence of PLMD. Fragmetned sleep suggests arousals with PLMs.
Against RLS: I belive one of the factors that stands out to me is that her job entails sitting all day, yet there does not seem to be any symptoms while on the job. Also, she does not descibe routine difficulty getting to sleep at night.
For OSA: obesity, fragmented sleep, resltess at night, tired and fatigued;
Against OSA: breathes easilt through nose, normal oropharynx, lack of signficnat snoring, low AHI.I think one of the first things to address is the possibility of depression. A number findings point to this conclusion: fibromyalgia, fragmented sleep, mentally challenged son, and PLM is often associated with depression. She is already on SSRI, perhaps this treatment has been ineffective.
She also has PLMD, with fragmented sleep. Alpha-delta sleep suggets sleep fragmentation (either from PLM or fibromyalgia. Again, becuase PLMD is asociated with dpression, this diagnosis is also improtant. Would also strongly ocnsider treating PLMD.