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?
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.
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