Sleep disorder (insomnia)
What should you cover in a 10 minute consultation, ask Bruce Arroll and colleagues
A 53 year old man comes to you complaining of not having slept well for many years. He always feels tired the next day. He has tried sleeping pills, which sometimes help, but he is not keen on taking them continually and has found that the benefits they give him don't last. He spends about 9-10 hours in bed each night (going to bed about 9 30 pm or 10 pm and getting up at 7 am) and has trouble getting to sleep. His actual hours of sleep are 5.5 to 6 each night. He wakes about three times a night and describes the quality of his sleep as poor.
Some patients find this regime quite difficult but within about two weeks find themselves sleeping much better and report a better quality of sleep. If they achieve this in a few weeks they can start increasing the time spent in