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INSOMNIA by Mind Map: INSOMNIA

1. Positive Key Features:

1.1. 44 yo white female presents to clinic with complaint of sleeplessness for "a few months." Pt works swing shift at Alabama Power. Pt has trouble falling asleep, but no issues staying asleep. Pt stated, "I have taken everything over the counter like Melatonin, ZzzQuil, Tylenol PM, Advil PM, but nothing really helps.”

2. Possible Dx's:

2.1. I.

2.1.1. Insomnia

2.1.1.1. is a sleep disorder that is characterized by difficulty falling and/or staying asleep

2.1.1.1.1. #1 matches patient best!

2.2. II.

2.2.1. Circadian Rhythm Disorders

2.2.1.1. are disruptions in a person's circadian rhythm—a name given to the "internal body clock" that regulates the (approximately) 24-hour cycle of biological processes in animals and plants.

2.2.1.1.1. possibility d/t pt's description of symptoms.

2.3. III. Sleep Apnea

2.3.1. is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea. The main types of sleep apnea are: Obstructive sleep apnea, the more common form that occurs when throat muscles relax.

2.3.1.1. not likely but needs to be a differential.

2.4. IV. Major Depressive Disorder

2.4.1. affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

2.4.1.1. not likely but will keep as a differential d/t symptoms

3. Vindicate

4. Psychiatric:

4.1. Depressive

4.2. Bipolar Disorder

4.3. Psychotic Disorders

4.4. Anxiety Disorders

5. Abuse/Withdrawal

5.1. Alcohol

5.2. Caffeine

5.3. Amphetamines

5.4. Hypnotics

5.5. Antineoplastics

6. Medical Conditions

6.1. Asthma

6.2. Allergies

6.3. Headache/Migraine

6.4. Head Injury

7. Other

7.1. Restless Leg Syndrome

7.2. Narcolepsy

7.3. Nocturnal Leg Cramps

7.4. Obesity

8. Negative Key Features:

8.1. Pt is prescribed Dextroamphetamine, but sleep pattern is the same regardless of taking sleep aids or not. Pt was prescribed Trazadone and took medication x3 months but "unable to tell a big difference." Last dose of Trazadone was x2 months ago.