YEAR-OLD WOMAN WITH TROUBLE
SLEEPING (INSOMNIA) LATEST EDITION
2026-2027 WITH ALL QUESTIONS AND
ANSWERS QUALIFIED 100% PASS!!!!
,1. Understanding the Case (Clinical Summary)
The patient is a 65-year-old woman who reports:
• Difficulty falling asleep (sleep latency >30–60 minutes)
• Frequent nighttime awakenings (3–5 times/night)
• Early morning awakening
• Total sleep time ~3–4 hours/night
• Daytime fatigue, irritability, poor concentration
• Symptoms occurring ≥3 nights per week for months
She denies:
• Snoring or apnea (rules out obstructive sleep apnea)
• Hallucinations or neurologic symptoms
• Acute medical instability
This pattern strongly suggests:
Chronic Insomnia Disorder Key exam clue:
Symptoms persist despite adequate opportunity to sleep.
Chronic Insomnia Disorder — Explained Clearly
Chronic Insomnia Disorder is a long-term sleep condition where a person has persistent
difficulty falling asleep, staying asleep, or waking too early, despite having adequate
opportunity to sleep, and it causes daytime impairment.
In simple terms:
The person wants to sleep, has time to sleep, but cannot sleep well for 3 months or longer.
Definition (Clinical Criteria)
According to standard clinical guidelines, chronic insomnia is diagnosed when:
• Difficulty initiating sleep, maintaining sleep, or early morning awakening
• Occurs at least 3 nights per week
• Persists for ≥ 3 months
, • Causes daytime impairment
• Happens despite adequate sleep environment and opportunity
Types of Insomnia Symptoms
1. Sleep Onset Insomnia
• Difficulty falling asleep
• Takes >30–60 minutes to fall asleep
2. Sleep Maintenance Insomnia
• Frequent nighttime awakenings
• Difficulty returning to sleep
3. Early Morning Awakening
• Waking up too early and cannot return to sleep
Many patients have a combination of all three.
Causes & Risk Factors
Chronic insomnia is usually multifactorial, meaning several factors contribute.
1. Psychological Causes
• Anxiety disorders
• Depression
• Chronic stress
• Trauma or grief
2. Medical Conditions
• Chronic pain (arthritis, cancer)
• Gastroesophageal reflux disease (GERD)