#MedicalCase

Sleep disturbance. (Psychiatry)

Dr. Vandana Andrews., MD PHYSICIAN

 

Medical Case Details:

52 years old banker. From last few months, he is not getting sound sleep. It looks as if he is awake and dreaming of different things mostly related to his work, and has at least one or two sleep breaks. When he gets up in the morning, he does not feel fresh. There is a heaviness in his eyelids. In the recent health checkup, two weeks back, all the parameters are normal. He is suffering from bronchitis for the last ten years. He takes 200mg of Foracort every morning. He also goes for a morning walk of around 3 to 5 KM, but not regularly. What could be the diagnosis?

 


    Discussions


    Dr. Indhupriyadharshini
    General Practitioner

    Hello

    The patient might be under Stress induced Anxiety which make him to move towards Sleeplessness, as you mentioned all the parameters are normal, it is suggestible to give him general counselling.

    If still he didn't show any progress Clonifit 0.25mg can be given and Cognitive behavior therapy can be done.

    Hope this helps
    Regards
    Dr.Indhu

    ▲ 2
    21.Feb, 06:49pm

    Dr. Vandana Andrews
    General Practitioner

    Thank you Dr Indhupriya .

    ▲ 1
    26.Feb, 09:15am

    Dr. Sreerag B Prasad

    ?OSAS, ?Narcolepsy

    What do you think about suggesting a polysomnography?

    01.Mar, 10:33am

    Dr. Robert Phares
    General Medicine Physician

    Agree with above. Needs sleep study or at least an overnight pulse oximetry. He has a history of chronic bronchitis, so nocturnal hypoxia may be occurring.

    ▲ 1
    02.Mar, 01:49am

    Dr. Nilotpal Dutta

    Before starting any benzodiazipnie or any sleep inducing drug, better to ho for PSG or pulse oximetry.. Till then CBT will be the best part of the treatment...

    22.Mar, 02:08am

    Dr. Tharaka Dushyan Thanthriarachchi
    Psychologist Counsellor

    Agree with Dr. Datta. Sleep studies are useful of course to rule out any biological cause. Most patients with sleep disorders are likely to benefit greatly from CBT.

    09.Apr, 03:14pm

    Dr. Saurav Kumar

    The patient is suffering from depression... please send him to a psychiatrist

    02.May, 10:54am

    Dr. Kumarshri Shriniwas Saraswat
    Psychologist Counsellor

    If all the parameters are normal and he does not fall asleep frequently during the day, obstructive sleep apnoea is unlikely.

    The bronchitis is chronic, he is taking steroid inhaler for the same and there is no history suggestive of acute worsening of bronchitis in either day or night,so it is unlikely to be related to his sleep issues.

    In depression, the quality of sleep is poor. Even after getting sufficient sleep, there is a feeling of not having slept enough. Excess dreams suggests that Rem sleep has increased and he is not getting enough deep sleep.

    I would recommend screening for depression and necessary treatment.


    15.May, 11:01pm

    Dr. Mahboob Ali

    According to unani system medicine concept. patient brain temprament is change normal to dryness due to age or bronchitis. it can be cure through herbal medicine through.


    05.Jun, 03:33am



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