Hypersomnia Diagnosis and Social Factors Case Study Presentation Oral Video Presentation with Slide show. Based on your Case Study from your Essay Analysis
Hypersomnia Diagnosis and Social Factors Case Study Presentation Oral Video Presentation with Slide show. Based on your Case Study from your Essay Analysis Paper, students will make Video oral presentation using Slide Show format. (video on your ipad and submit to Canvas) Compress your video before submitting – limit your presentation to 5-8 minutes. With the use of documentation and examples from the case study or film, the students will present how this character has exemplified the course and development of a disorder. For the main character you will include the following topic headings in your slide show presentation: Introduction (describe the case and the character); Diagnosis – include symptoms from DSM V and examples of characters behavior; Etiology (causes of the Problem); Social Factors (family or living conditions); Treatment Plan (type of therapy or medications); and Conclusion..
Students will prepare slides (no more than 6-7 slides) which will accompany the oral presentation of the project. Movie clips or trailers may not be embedded into their power point presentation. See Rubrics for Writing and oral presentation under materials. You must video record your presentation on your iPad and submit it to canvas along with the Slide Show.
Do NOT CUT and PASTE paragraphs from your paper into the slide show presentation. Power Point works best for Slide show. Brief summary statements only. Do not read your paper in your presentation. No more than 6 lines per slide.
Slide 1. Introduction (short description of case study);
Slide 2: Diagnosis – include symptoms from DSM 5 and examples of your characters behavior;
Slide 3. Etiology (causes of the Problem i.e. Heredity, Psychological )
Slide 4. Social Factors (family or living conditions that could influence the problem)
Slide 5. Treatment Plan (type of therapies or medications)
Slide 6. Conclusion.
Slide 7. References (make sure you include reference slide) .
Instructions to upload
2. Save it somewhere (best to save it to ARC on left navigation )
3. Open Canvas
4. Open the Video Presentation Assignment
5. Select the Submit Assignment – it’s Blue to right
6. Select the ARC tab
7. Select the +Arc top right
8. Browse to find your saved video
9. Hit “select this” and confirm then submit your assignment Running head: CASE STUDY ON HYPERSOMNIA
Case Study on Hypersomnia
Students Name
Institutional Affiliations
1
CASE STUDY ON HYPERSOMNIA
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Table of Contents
Case Study on Hypersomnia …………………………………………………………………………………………….. 3
Introduction ………………………………………………………………………………………………………………… 3
Diagnosis ……………………………………………………………………………………………………………………. 4
Etiology ……………………………………………………………………………………………………………………… 6
Biological Causes …………………………………………………………………………………………………….. 7
Psychological Causes ……………………………………………………………………………………………….. 8
Social Causes …………………………………………………………………………………………………………… 8
Treatment …………………………………………………………………………………………………………………. 10
Prognosis ………………………………………………………………………………………………………………….. 13
Conclusion………………………………………………………………………………………………………………… 13
References ………………………………………………………………………………………………………………… 15
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Case Study on Hypersomnia
Introduction
Hypersomnia or sleep-wake disorder is a sleep disorder characterized by excessive
sleepiness, leading to reduced functioning, which impacts on performance negatively. Patients
with this order often experience problems staying awake and attentive during major waking
episodes, leading to an uncontrolled sleeping pattern. Hypersomnia can be categorized into
primary hypersomnia and the recurrent hypersomnia (Ohayon, 2009). The former is characterized
by excessive sleepiness over months or years but does not occur within regular periods. In the
latter, the symptoms last for many years, but there are times when an individual is free from all the
symptoms. However, the two types of hypersomnia are both characterized by long nap periods
during the day, thus interrupting the schedules of the affected (Ohayon, 2009). Also, the frequent
naps and more than seven hours of sleep during the night do not seem to refresh the individual.
For hypersomnia, the symptoms present themselves gradually and may either worsen or get better
with time.
It is essential to diagnose and treat the disorder as soon as it is discovered because of its
severe impacts. For instance, people with the disease may be involved in car accidents if they fall
asleep in traffic. They could also sustain injuries from tripping, falling, and other forms of
disasters. Prolonged hypersomnia can also impede the ability of an individual to fulfill their
professional duties and maintain good social relationships. The disorder can also affect an
individuals well-being due to insecurity concerning their health.
The case study seeks to highlight the symptoms and causes of the disorder by conducting
a review of a twenty-year-old male, who is my brother named JM. I recently noticed that he might
be suffering from the sleep-wake disorder, also known as hypersomnia. I can relate his symptoms
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to the condition because he has been complaining of the inability to control daytime sleepiness
even after sleeping for more than seven hours at night. Moreover, he always looks tired, confused
and unable to perform simple mental and physical tasks.
Diagnosis
In the past month, I had noticed a significant reduction in my brothers functioning, in
terms of his social interactions and overall work performance. He has also had difficulties
remembering information, always fatigued, and seems confused most of the time. However, before
I could conclude that JM is suffering from hypersomnia, I had to ask him several questions
centered on the time he first noticed the drowsiness, his overall sleeping pattern and environment
and an evaluation of current medication that could be contributing to the sleepiness. From my
questioning, I deduced that he had five main symptoms. I categorized the symptoms using the
DSM 5 method as follows:
Symptom 1 falling asleep severally during the day.
Symptom 2 feelings of confusion or combativeness when trying to wake up from sleep
Symptom 3 Experiencing difficulties when trying to wake up from sleep
Symptom 4 Feeling tired even after sleeping for more than nine hours
Symptom 5 taking naps to counter the sleepiness but failing to wake up refreshed
JM noted that he still felt unrested even after sleeping for long hours. Thus, upon waking
up, he always felt sleep deprived. Further, he also experienced sleep drunkenness, which barred
him from thinking clearly each time he woke up. He stated that he experienced a foggy feeling
upon awakening and experienced difficulties performing simple physical and mental tasks.
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Additionally, JM often experienced sleep inertia, which caused him to have problems waking up
accompanied by confusion and dizziness.
During the questioning, I created a possible sleeping diary which showed his sleep and
awake times both during the day and at night. However, it was necessary to ascertain the
information, and I, therefore, asked him to keep a sleeping diary for the next seven days. I asked
him to record the time he went to bed, the number of hours he sleeps and the waking time. I
discovered that his sleeping pattern was characterized by long sleeping times during the day and
at night. Apart from the diary, I also utilized the Epworth Sleeping Scale, which is a scale
containing eight items essential in measuring sleepiness (Banerjee, 2007). I asked him to rate his
probability of sleeping on a scale of 1 to 3 while engaged in specific activities. The scale would
determine if he had a normal or abnormal sleeping pattern (Banerjee, 2007,). A score of 3 means
that one has a high chance of falling asleep while a score of I points to a slight chance. Upon filling
the form, the following were his test results
Situation
Score
Sitting and reading
3
Watching television
3
Sitting inactive in a public place (e.g. a theatre/meeting) 3
As a passenger in a car for an hour with no break
3
Lying down in the afternoon (when possible)
3
Sitting and talking to someone
1
Sitting quietly after lunch without alcohol
3
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In a car, while stopped for a few minutes in traffic
1
Total
20
From his test results (20), it was evident that he had an exceedingly high level of daytime sleepiness
that required medical intervention.
Though I had already performed the two self-examines tests, I felt the need to complete a
Multiple Sleep Latency Test, which would make a clear distinction between fatigue and
hypersomnia (Waihrich, Rodrigues, Silveira, Fróes, & Rocha, 2006). Ordinarily, people confuse
between the two, but the latter denotes the ability to fall asleep. The test was performed in a clinic,
and it sought to determine how fast JM fell to sleep with little simulation (Waihrich et al., 2006).
The test was also to establish how soon he would enter REM sleep. During the test, JM was allowed
to fall asleep, but the clinicians would often wake him up after twenty-minute intervals. After the
test, it was established that JM had an MLST of under seven minutes, pointing to possible
excessive daytime sleepiness.
Apart from the tests, I noted that JM had been involved in an accident at his workplace. He
had been accidentally hit by a blunt object, during one of the breaks. As such, he had been taking
medication to relieve the pain. Furthermore, his sleeping environment was in no way related to his
sleeping patterns because he fell asleep randomly in various places. Therefore, for the diagnosis,
the three tests utilized were sleeping diary, Multiple Sleep Latency Test and the Epworth Sleeping
Scale. Backed by the symptoms, the three results indicated that JM was suffering from hyper
insomnia. I then sought to understand the causes of the sleep disorder.
Etiology
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Biological Causes
One of the primary causes of hypersomnia is a Traumatic Brain Injury (TBI). Such injuries
tend to alter the functioning and output of the nucleus suprachiasmatic, causing disruptions in the
circadian rhythm, which then leads to both insomnia and hypersomnia (Viola-Saltzman & Musleh,
2016). These injuries are often caused by motor vehicles and construction accidents, physical
assault, and impact from objects. TBI can be categorized as either mild, moderate or intense
depending on the severity of the symptoms. In this case, however, the conclusion is that the brain
injury was severe because of the results acutely or develop as a long-lasting problem during the
recovery period, which could be years after the injury (Viola-Saltzman & Musleh, 2016). Further,
sleep disorders can also deter the recovery process after the TBI. Apart from hypersomnia, other
sleep disorders associated with TBI are circadian rhythm and sleep-related breathing disorders.
Apart from TBI, sleep disorders have a genetic element (Charrier, Olliac, Roubertoux, &
Tordjman, 2017). Therefore, clinicians often acquire information concerning possible
hypersomnia in the family before making a diagnosis. Other disorders occurring in the family
should also be noted particularly those related to the nervous, endocrine and mental systems.
Additionally, clinicians often enquire on the history of obesity, suicidal tendencies, and
psychological disorders. Apart from the family history, it is also essential to obtain the personal
history of the patient, which could be contributing to hypersomnia. Thus, illnesses related to the
brain, endocrine system and use of toxic substances are often noted. Therefore, the biological
causes of hypersomnia are not limited to TBI because there are those related to the family and
personal history of the patient.
In this case, the biological factor contributing to Jms hypersomnia is the brain injury
sustained at his workplace. Therefore, the interruption in the functioning of his brain could be
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adding to daytime sleepiness, drowsiness, and confusion. However, his family and personal history
are in no way linked to his sleep disorder. That means that the clinicians did not establish
complications connected to the nervous system or psychological dysfunction.
Psychological Causes
Hypersomnia is also associated with mental disorders such as depression, Parkinsons
disease, and Alzheimers disease. For instance, individuals suffering from depression often
experience severe symptoms of both insomnia and hypersomnia (Dauvilliers, Lopez, Ohayon, &
Bayard, 2013). Thus, chronic sleepiness becomes a form of escape from the harsh world. Further,
these psychological disorders cause patients to feel weak and physically ill, leading to more
extended hours of sleep. Additionally, hypersomnia emanates from the fact that individuals with
various mental disorders often experience feelings of unhappiness and emptiness, causing to sleep
exceedingly. Thus, these people sleep most of the days, take many naps during the day, retire to
bed early and are late to wake up.
In some patients, hypersomnia can be mistaken for depression (Dauvilliers, Lopez,
Ohayon, & Bayard, 2013). Thus, the chronic sleeping causes one to miss appointments, fail to
finish simple tasks and unavailable for loved ones. The isolation coupled with depression causes
an individual to desire long sleeping hours. Though psychological causes are a common cause of
hypersomnia, they were not mentioned in JMs case. The health professionals established that JM
does not have psychological disorders such as depression, Alzheimers and Perkinsons disease.
With this discovery, it was easier for them to identify the best treatment methods for his condition.
Social Causes
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Use of addictive substances such as alcohol, marijuana, and cocaine tends to increase the
severity of hypersomnia symptoms (Mahfoud, Talih, Streem, & Budur, 2009). Individuals with a
history of substance abuse and hypersomnia tend to have a substantial sleep time during the night,
while drowsiness and frequent naps characterize their day time. There are drugs which cause
negative impacts on the Central Nervous System by increasing sleepiness. However, withdrawal
from these stimulants also activates hypersomnia symptoms. Continued use of these substances
may trigger additional sleep problems, resulting in daytime sleepiness. Further, continued use or
withdrawal can result in hypersomnia.
For starters, alcohol consumption impedes with the chemicals found in the brain. The
central role of these chemicals is controlling sleep and subduing REM sleep, a stage that is
connected to sleep restoration (Mahfoud et al., 2009). Further, alcohol not only causes individuals
to sleep for long hours but also interferes with their sleeping patterns. Therefore, alcohol is a major
cause of hypersomnia because its consumers experience sleeping problems, awake several times
during the nights, experience sleepiness during the day and generally have a poor quality of sleep.
The impacts of alcohol are more pronounced when the drink is consumed late in the evening or
during bedtime.
Apart from alcohol, abuse of marijuana causes hypersomnia because the drug affects the
normal sleeping patterns and further impacts brain chemicals associated with inducing sleep
(Mahfoud, et al., 2009). Therefore, just like alcohol, marijuana use tends to overpower REM sleep.
Though marijuana starts by promoting sleep, consistent or discontinuation of use can affect the
sleep quality of an individual negatively. In addition to marijuana and alcohol, some stimulants
lead to hypersomnia. These substances enhance the release of the dopamine hormone in the brain,
which is crucial for remaining awake.
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Chronic use of addictive substances such as marijuana, alcohol, cocaine and some
stimulants often trigger the symptoms of hypersomnia. Alternately, the withdrawal from the same
can also lead to the disorder. However, JM admitted to the clinicians that he only consumes alcohol
occasionally and therefore cannot be deemed as addicted to either of the drugs. Thus, as an
occasional drinker, his symptoms do not have any correlation with the substance because the signs
have been occurring continuously. I also noted that JM spends most of his time at work or at home,
where he performs minimal activities.
Treatment
There are several recommended Treatments of hypersomnia depending on the severity
and etiology of the problem. For instance, therapies and counseling alter the behavior, nonpharmacologic options, pharmacologic regimens, and lifestyle changes are some of the methods
that cure the sleeping disorder. For starters, patients without primary conditions such as
narcolepsy and apnea, may get help by applying nonpharmacologic options, which might help to
normalize the pattern of the sleep (Siegel, Badr, & Krieger, 2005). For instance, people with
voluntary sleep challenges may need to alter their sleep hygiene. Sleep hygiene approach is most
suitable for treating people with work disorder. In this case, de-harmonization happens between
the quotidian rhythm and existing chances to rest within the daily plan of the patient.
The most affected with this disorder are the people working night shifts, although it may
also affect those working in irregular shifts. Excellent sleep hygiene calls for a well-structured
tactic and timing of sleeping and waking up. An individual should ensure that they rest in an
environment that is conducive to sleep. For example, a dark room or use of eye masks may
create such a setting. At the same, one may use earplugs and dulling loud sounds. Another
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approach to good sleep hygiene is ensuring that one is exposed to light during the waking hours,
while also avoiding excessive exposure to light, which may result in a delayed period of sleep
(Siegel, Badr, & Krieger, 2005). Also, going to bed at a specific time every night, while avoiding
sleeping during the day is another solution to hypersomnia. Also, one should avoid depressant
such as alcohol because it disrupts sleep. Additionally, medications and tobacco, which stimulate
wakefulness should be avoided, mainly when one is about to sleep. Although exercise is an
excellent recommendation for treating this problem, one should avoid it when they are almost
headed to bed (Siegel, Badr, & Krieger, 2005). Therefore, exercising is advised because it helps
a person to remain in excellent shape, as studies have revealed there is a strong relationship
between apnea and obesity.
Light therapy and chronotherapy are the two primary recommended nonpharmacologic
therapy available for patients with delayed sleep syndrome (Siegel, Badr, & Krieger, 2005). The
latter involved altering the bedtime hours forward by some hours until the time when one will
reach the desired sleep time. After entering this time, a disciplined approach is used to lock the
bedtime through having wake-up calls, alarms, cohabitants helping to enforce a consistent sleep
regimen. Though a less radical approach, light treatment occurs through exposing an individual
to bright light during their waking hours. The technique has an alerting effect, which is
impacting the circadian rhythm.
Another treatment for the sleep disorder involves the use of drugs after the
nonpharmacologic approach fails. All the medicines of the patients should be reviewed to
determine whether they are affecting the sleeping pattern of the affected person. Some of the
suggested treatments include the use of stimulants, antidepressants, hypnotics, modafinil, and
melatonin. The hypnotics are used to standardize the sleep schedule because they treat over a
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short period. The most employed treatment is Benzodiazepine receptor agonists because they
have a positive impact on the day and night symptoms (Siegel, Badr, & Krieger, 2005). Patients
that need to be alert in the day may be prescribed Short-acting benzodiazepines. However, those
with sleep disorders that experience anxiety may be recommended to use longer-acting
medications. However, long term exposure to hypnotic to treat sleep disorder is not endorsed, in
part, because they may have side effects, and only mask the disorder instead of curing it entirely.
Stimulants are another treatment that can help bring sporadic symptom reprieve. For
instance, to treat narcolepsy, Dextroamphetamine and methylphenidate are the recommended
medications. The former may be divided into doses of between five and sixty mg/d, while the
latter may be used up to 60 mg/d, bid or lid (Siegel, Badr, & Krieger, 2005). There is a need to
monitor patients using these medications to avoid cases of drug abuse. Concomitant insomnia
associated with depression may also be addressed through sedative antidepressants. However,
the issued antidepressants should be tailored to meet the needs of the patients. Melatonin, a
hormone found in the pineal gland, has a different reaction to the circadian rhythm as compared
to bright light. Therefore, it is a treatment approach for those experiencing delayed sleep period
signs. One may be prescribed to use 3-mg early dosage, which may increase to reach 10-mg
(Siegel, Badr, & Krieger, 20…
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