NURS 6670: Week 10: Case Study: Assessing Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea
Case Study: Assessing Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea
NURS 6670: Week 10: Sleep/Wake Disorders and Parasomnias Assessment
NURS 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults | Week 10
Tick, tock, and here we go again. I have been in bed trying to go to sleep for three hours now. I have not gotten more than a few hours of sleep a night in months. My work is being affected and so is my relationship with my wife. She’s over there sleeping like a baby and cannot understand why I can’t sleep. ‘Just close your eyes and relax’, she says. When I close my eyes, all I see is all the work I have to do.
Riley, age 34
Sleep is essential for a healthy mind and body, and lack of quality sleep can cause distress during the daytime. Sleep disorders can involve difficulties with quality, timing, and amount of sleep and frequently accompany other disorders, especially depression, anxiety, and PTSD. Obtaining a good sleep history is essential to diagnosing sleep disorders, prescribing a treatment plan, and monitoring the plan’s effectiveness. Understanding and managing sleep problems frequently leads to improvement in other mental health disorders that the patient is experiencing.
This week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.
Learning Resources – NURS 6670: Week 10: Case Study: Assessing Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 13, “Psychosomatic Medicine” (pp. 465–503)
- Chapter 16, “Normal Sleep and Sleep-Wake Disorders” (pp. 533–563)
Note: This is review from the Learning Resource in Week 3.
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
- Chapter 36, “Sleep-Wake Disorders”
Note: You will access this book from the Walden Library databases.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- “Sleep-Wake Disorders”
Note: You will access this book from the Walden Library databases.
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.
To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
| Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea syndrome, shift work sleep disorder | Insomnia | Narcolepsy | Restless leg syndrome |
|---|---|---|---|
| armodafinil modafinil sodium oxybate (in narcolepsy only) |
agomelatine alprazolam amitriptyline amoxapine clomipramine clonazepam desipramine diazepam dothiepin doxepin estazolam eszopiclone flunitrazepam flurazepam hydroxyzine imipramine lofepramine lorazepam maprotiline mianserin nortriptyline quazepam ramelteon temazepam trazodone triazolam trimipramine zaleplon zolpidem zopiclone |
amphetamine (d) amphetamine (d,l) lisdexamfetamine methylphenidate (d) methylphenidate (d,l) modafinil sodium oxybate |
gabapentin ER |
Optional Resources
Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., . . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. doi:10.1037/ccp0000084
Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015). Cognitive and mood dysfunction in adult obstructive sleep apnoea (OSA): Implications for psychological research and practice. Translational Issues in Psychological Science, 1(1), 67–78. doi:10.1037/tps0000021 Case Study: Assessing Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea
Discussion: Treatment of Sleep/Wake Disorders Nursing Paper
The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.
In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.
Learning Objectives
Students will:
- Analyze diagnostic criteria for sleep/wake disorders
- Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders
- Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders
- Compare differential diagnostic features of sleep/wake disorders
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
To prepare for this Discussion:
- By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion.
- Review the Learning Resources.
By Day 3
Post:
- Explain the diagnostic criteria for your assigned sleep/wake disorder.
- Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.
- Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.
- Support your rationale with references to the Learning Resources or other academic resource.
By Day 6
Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. NURS 6670: Week 10: Case Study: Assessing Excessive sleepiness in narcolepsy, obstructive sleep apnea/hypopnea.
