Insomnia

Question 1

25yo F presents with a 3 week history of difficulty falling asleep. She sleeps 7 hours per night without nightmares or snoring. She recently began college and is having trouble with her boyfriend. She drinks 3-4 cups of coffee a day.

Answer 1

STRESS-INDUCED INSOMNIA
caffeine-induced insomnia
insomnia with circadian rhythm slew disorder
insomnia related to major depressive disorder

polysomnography
mental status exam
urine toxicology
cbc
tsh

Question 2

55yo obese M presents with several months of poor sleep, daytime fatigue, and morning headaches. His wife reports that he snores loudly

Answer 2

OBSTRUCTIVE SLEEP APNEA
daytime fatigue in primary hypersomnia
insomnia with circadian rhythm sleep disorder
insomnia related to major depressive disorder

Question 3

33yo F c/o 3 weeks of fatigue and trouble sleeping. She states that she falls asleep easily but wakes up at 3AM and cannot return to sleep. She also repots an unintentional weight loss of 8 lbs and an inability to enjoy the things she once liked to tod

Answer 3

INSOMNIA RELATED TO MDD
primary hypersomnia
insomnia with circadian rhythm sleep disorder

mental status exam
tsh
cbc
polysomnography