Running head: Extreme Daylight Sleeping Syndrome

Extreme Daylight Sleeping Syndrome

Student’s Name

University Affiliation
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Excessive sleep during the day, also known as EDS, is as a result of persistent

sleepiness often due to lack of energy in the body. The excessive daytime sleeping

syndrome is a broad disorder that includes sleeping maladies that are both prolonged

during the day and night.

1. What scale or screening tool would be most appropriate for David?

David Gregory is a 75-year-old man, experiences the disorder of excessive

daytime sleep as it is an anticipated expectation for the old adults. Three item instruments

are the most appropriate tool in screening daytime sleeping problems. DerSarkissian

argues that currently, there is still no valid scale for measuring the amount of sleep for the

elderly (2019). 'The Surveillance in addition to interviewing Diurnal sleepiness portfolio

also known as ODIS is a brief step by step methodology that is easy to maneuver when

attending to the three-item instrument, in the attempt to screen excess daytime sleep

(DerSarkissian, 2019). ODSI scores portray a possible potential for clinical convenience.

In his article, Zhang argues that ODSI scores usually range at six or above to some of the

patients who experience OSA disorder (2006). The three-item screening tool

encompasses various characteristics that involve reliability, resulting from internal

steadiness. The screening tool provides reliability properties due to its capacity to hold

high test-retest besides it is validity. According to Rosenberg, the correlation existing

between ODSI and the longer ESS becomes acceptable when it reaches Pearson r=0.69

(2015). Thus the receiver operator analysis reveals that score 6 is the effective cut off

point to identify the older individual with the daytime sleeping syndrome

. 2. What diagnosis would you give David, and what are some differential diagnoses?
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I would give David a complete clinical interview since it is the most critical

assessment module for understanding any sleeping disorder. A clinical interview is

essential since it plays a crucial role in deriving a perfect diagnosis. Some of the

differential diagnoses involve; primary type of hypersomnia that include idiopathic

hypersomnia, narcolepsy not forgetting the intermittent hypersomnia. Secondly is

secondary hypersomnia, which comprises various disorders. The disorders are inclusive

of encephalitis, obesity cases, nevertheless clinical despair in addition to numerous

sclerosis, among others. Hypersomias that is posttraumatic can sometimes result from

brain injury. It is evident that the level of sleepiness closely correlates to injury severity.

3. What medication would you start him on? Please include the starting dose and

medication education instructions for this David.

It is very crucial for a patient to exhaustively explain to the doctor how they feel

without omitting any observation as it acts as a guide to the doctor giving out medical

prescriptions. Thus David should produce a complete picture of both physical besides

mental health. David needs to start taking Sodium oxybate, a medication that improves

the eminence of sleep and manages the symptoms of sleeping disorder. The starting dose

entails; Provigil. David should take 200-400mg/d, whereby he should commence by

taking 100 mg/d and eventually increase after two to three days (Rosenberg, 2015).

David should take half a dose at bed and the other half later on after four hours.

4. What non-pharmacological treatments would you recommend and why?

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I would recommend David to make use of stimulus control, besides trying to restrict

himself from much sleeping. David should practice good sleeping hygiene by making

sure he avoids stimulants like caffeine the time he goes to bed, he should also try to limit

his sleeping time during the day by limiting the naps to duration of 30 minutes. In his

article Peto argues that an approximate of 70 to 80 % number of patients who receive

nonpharmacological therapy benefit from it (2017). The type of treatment in discussion

leads to an improvement in sleeping, an achievement that is able to last the next 6 months

after treatment process.

5. What referrals would you make for David?

There are various referrals that I can refer to David Gregory starting with; he

should make an attempt of meeting the sleep specialist who operates in the secondary

care department for further assessment where necessary. Finally I can also refer David to

a more careful valuation in addition to further investigation since it will lead to a

substantial improvement in the quality of lives he lives.

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References

DerSarkissian, C. (2019). Diagnosing Hypersomnia. Retrieved from

https://www.webmd.com/sleep-disorders/daytime-sleepiness.

Ghode, R., Ouyang, B., Bernard, B., Stebbins, G., & Goldman, J. (2012). Excessive Daytime

Sleepiness, Sleep Quality, and Cognitive Impairment in Parkinson's Disease

(P06.053). Neurology, 78(Meeting Abstracts 1), P06.053-P06.053. doi:

10.1212/wnl.78.1_meetingabstracts.p06.053

pető, n. (2017). evaluation of the Brussells Questionnaire as a screening tool for obstructive sleep

apnea syndrome. New Medicine, 21(1), 3-7. doi: 10.5604/01.3001.0009.7834

1016/j.jalz.2018.06.1033

Rosenberg, R. (2015). Clinical Assessment of Excessive Daytime Sleepiness in the Diagnosis of

Sleep Disorders. The Journal Of Clinical Psychiatry, 76(12), e1602-e1602. doi:

10.4088/jcp.14019tx2c

Schapira, A. (2004). Excessive daytime sleepiness in Parkinson's disease. Neurology, 63(Issue 8,

Supplement 3), S24-S27. doi: 10.1212/wnl.63.8_suppl_3.s24

Zhang, W. (2006). P2-343: Clinical Features, Iron Metabolism And Inflammation: New Insight

Into Excessive Daytime Sleepiness In Parkinson Disease. Alzheimer's &

Dementia, 14(7S_Part_15), P817-P817. doi: 10.1016/j.jalz.2018.06.1033