macintosh
Forum Elite
Topics: 38
Posts: 178
|
A 67-year-old man comes to the physician
because of insomnia for
2 years. He goes to bed at 11:00 PM after taking a
bath but does not
fall asleep until midnight. He usually wakes up twice
each night: once
around 3:00 AM to void and again at 6:00 AM. He stays
in bed until his
alarm goes off at 7 AM. He is concerned because he
used to sleep 8
hours daily. He recently retired from his job as an
attorney. He takes
no medications. He drinks one beer with lunch 3 days
each week and one
glass of wine with dinner each evening. He walks 1
mile daily after
dinner. Physical examination shows no abnormalities.
His mood is
neutral, and cognition is intact. Urine toxicology
screening is negative.
Which of the following is the most likely cause of
this patient's
symptoms?
A
) Advanced sleep phase syndrome
B
) Alcohol abuse
C
) Delayed sleep phase syndrome
D
) Major depressive disorder
E
) Melatonin deficiency
F
) Poor sleep hygiene
G
) Normal aging
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| macintosh
Forum Elite
Topics: 38
Posts: 178
|
My answer is G) Normal aging, since everything seems normal about the person in the question. Still may any explain how this choice can be differentiated from the other choices, especially choice F
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| Dr_Cosme
Forum Junior
Topics: 7
Posts: 58
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answer is G. Elderly patients have a decline in Delta sleep (stage 3 and 4).
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| Tiff
Forum Guru
Topics: 49
Posts: 500
|
 Agree. This is G - normal aging. With increased age there is decreased stage 3 & 4 sleep. Longer time to fall asleep and early morning wakening is characteristic.
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