Nowadays insomnia which means one’s having difficulties with falling and staying asleep is a widespread problem. According to Buysse, Rush, and Reynolds (2017), intermittent sleep or too early awakenings are also considered to be the symptoms of the disease. However, it should be mentioned that these signs are regarded as a problem only if they disturb a patient because people have different needs for sleep and the norm in this respect is defined individually. While treating insomnia, many factors should be taken into consideration, including other ailments a person has or has had, and his or her family history. The purpose of this paper is to analyze the case of S.H., who is 47 and suffers from insomnia, hypertension and perimenopausal symptoms and select the proper treatment for the patient.
The goals of therapy for S.H. include tackling the issue of insomnia and treating high blood pressure, mood swings and night sweats which might be aggravating the situation by preventing the patient from sleeping well. Researchers note that while experiencing sexual involution, every third woman has sleep disturbance (Buysse et al., 2017). Reducing the effect of menopause symptoms on the female body will contribute to treating insomnia and achieving a normal, sound sleep. The main measure against climax is the woman’s changing lifestyle, for example, by including evening walks in her daily routine.
Besides, hypertensive patients often have superficial sleep and take drugs that might affect their falling and staying asleep negatively. Since S.H. did not report the problem of insomnia to her health care provider and self-treated the sleep disturbance with OTC Tylenol PM, the ailment has become protracted. Therefore, in this case, a consultation with a cardiologist might be recommended. One more important fact to consider is S.H.’s mother’s having diabetes that is a hereditary illness. Sleep problems in people with diabetes occur amid failures of body systems. The most common ground is a hypoglycemic condition when one experiences an acute lack of glucose. That is why it is significant for S.H. to attend an endocrinologist and have specific tests done. All in all, the case under analysis is a complicated one because the problem of insomnia is accompanied by several other conditions that might contribute to the woman’s difficulties in falling asleep. Hence, apart from taking an anti-insomnia drug, S.H. should go to an endocrinologist and cardiologist and improve her lifestyle.
Speaking about the drug, I would prescribe Zolpidem (Ambien) which allows achieving an instant effect and improves the situation in the short-term. It is appropriate for the case because it will help the woman immediately while her having medical examinations by other specialists. The parameters for monitoring the success of the therapy are S.H.’s good sleep quality and general condition. Specific patient education based on the therapy prescribed includes raising the woman’s level of responsibility for her health and changing her negative attitude towards taking medication. Zolpidem’s adverse effects include nausea and diarrhea; if S.H. complained about these, I would change the way of treatment. The second-line therapy would be Temazepam (Restoril) which has a stronger effect (Santos-Longhurst, 2018). As for drug-to-drug and drug-to-food interactions, Zolpidem must not be taken together with opioid drugs; consuming alcohol is also prohibited (Santos-Longhurst, 2018). For S.H. such OTC as valerian root or Benadryl might also be appropriate. In addition to taking drugs and having medical checks, the woman should be more physically active and eat bananas, nuts, or black cherry every day. Such a diet will contribute to tackling the issue of insomnia.
To sum up it is significant to press the point that S.H. suffers from several conditions that might aggravate insomnia. Therefore, apart from taking Zolpidem, a drug against sleep disturbance, having additional medical checks is recommended. Moreover, changes should be brought to the woman’s lifestyle and eating habits. Being more active, for example, walking in the evening every day, and consuming more bananas, nuts, and black cherry will help S.H. to get rid of the difficulties with falling and staying asleep.
References
Buysse, D. J., Rush, A. J., & Reynolds, C. F. (2017). Clinical management of insomnia disorder. Jama, 318(20), 1973−1974.
Santos-Longhurst, A. (2018). What is Chronic Insomnia and How to Treat It. Web.