Posted by QA on April 13, 2003 at 15:08:36:

A 50 year old male with terrifying awakenings

A 50 year old man is referred to the office for difficulty initiating sleep over the last year. Lately his insomnia has seemed worse. he states he is afraid to fall a sleep because of his night time episodes.

2 hours after sleep onset the patient awakes diaphoretic with a sensation of throat tightening and ' rigid' with fear. he notices palpitations. he gets up and gets some air and takes glass of water. On one occasion her called an ambulance because he thought he was having a heart attack. the cardiac work up was unremarkable.
the patient denies any associated dreams and has no recollection of nightmares. he has no bed partner but doesn't believe he snores. he is on no medications though occasionally he takes Rennies for heart burn . he denies ' feeling anxious' but seems defensive on questioning

what treatment options would you recommend?
how might you further evaluate the patient
why does the patient have insomnia

Follow Ups:

• Re: Unusual Case Strohl 16:41 4/13/03 (0)
• Unusual Case (answer) QA 16:32 4/13/03 (0)

---

Post a Followup

Name    :  (required. Do not use real name. No time for removal later. Search engines will find you)
E-Mail  :  (use someone@sleepnet.com to avoid spam email, search engines,etc.)

Subject :  (change if you like)

Comments:


 

PLEASE ONLY CLICK THE SUBMIT FOLLOW UP BUTTON ONCE!!. Thanks, Sandman

---

[ Follow Ups ] [ Post Followup ] [ SSM Part 2 Forum ] [ FAQ ]

WWWBoard 2.0a and WWWAdmin 2.0a © 1997, All Rights Reserved.
Matt Wright