INSOMNIA

INSOMNIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is there dyspnea? If there is a history of dyspnea, heart disease or lung disease should be suspected.
2. Is there a history of drug or alcohol ingestion? There are many drugs that may cause insomnia, including the amphetamines, theophylline, caffeine, anticonvulsants, nicotine, thyroid hormones, and the sympathomimetics. Alcohol may induce sleep, but patients complain of early morning wakening.
3. Is there a history of a painful condition? Abscessed teeth, arthritis, sciatica, bone metastasis, hiatal hernia, and esophagitis are just a few of the conditions that may keep a patient awake because of pain.
4. Are there other psychiatric symptoms? Anxiety, loss of libido, loss of appetite, and depression may be associated with hyperthyroidism, general paresis, organic brain syndrome, chronic anxiety, and endogenous depression.

DIAGNOSTIC WORKUP

Routine studies include a CBC, sedimentation rate, urinalysis and drug screen, chemistry panel, thyroid profile, VDRL test, EKG, and chest x-ray. Arterial blood gases and pulmonary function testing should be done to rule out pulmonary disease. A venous pressure and circulation time will help rule out early congestive heart failure. Blood pressure monitoring can be used to rule out paroxysmal hypertension. If an organic brain syndrome is suspected, a CT scan or MRI of the brain should be done. If psychiatric symptoms are present, the patient should be referred to a psychiatrist. Alternatively, a therapeutic trial of psychotherapeutic agents may be initiated if the patient is not suicidal. When all of the above diagnostic tests are negative, a sleep study must be done. However, home monitors for apnea and oxygen desaturation are available and may be an inexpensive alternative to rule out obstructive sleep apnea.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

More About Sleep deprivation

• Back to disease: Sleep deprivation: Introduction
• Next Book Extract About Sleep deprivation: Insomnia (In a Page: Signs and Symptoms)
• More Book Extracts: All Online Books for Sleep deprivation

More Medical Textbooks Online about Sleep deprivation

Review other book chapters online related to Sleep deprivation:

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

 » Next page: Insomnia (In a Page: Signs and Symptoms)

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• Insomnia (In a Page: Signs and Symptoms)
• INSOMNIA (Differential Diagnosis in Primary Care)
• Insomnia (Handbook of Signs & Symptoms (Third Edition))
• Insomnia (Professional Guide to Signs & Symptoms (Fifth Edition))
• Insomnia (The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)

Tools & Services:

• Bookmark this page
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com

Common Health Mistakes

Symptom
Checker

Search Specialists by State and City