Sleep pattern and quality improved without sleeping pills

Ms. R.P.P mentioned having some disturbances in her sleep pattern. She would be awake for long hours before she could actually fall asleep. Her sleep would be disturbed due to unnecessary thoughts. Her mind would be filled with all negative thoughts. She would feel sleepy and unrefreshed during the waking hours. She had not started with any treatment so far but the severity of her complaints had increased so much that she would have sleepless nights for days together. Since she was sleepless at night times, the whole day she would feel very sleep and tired all the time. She would get sleep around 2-3 am in the morning. Her case was taken in details. She was a vegetarian and her appetite was excessive, she could not tolerate being hungry. She had excess liking for sweets and milk products. Her thirst for water was average. She mentioned having excess sweating more on her forehead. She could not tolerate excess of heat and thermally was a hot patient. Her bowel and urine habits were normal. Her menses were delayed and irregular, she also mentioned her sleeplessness getting aggravated before menses. Due to the sleeplessness for so long, she had started becoming very irritable and was losing patience on small matters. On Dr. Shah's advise she had got her Thyroid levels checked, the values were with in normal limits. Her case was taken in details, She was a home maker and her husband was working in a private sector. They had a 4 year old son who was studying in school. From child hood she was always dominated by her parents and always felt neglected as a child. The domination was so much that once she had even tried to run away from home as she couldn't tolerate her parents constantly pressing her. She always felt that her parents are worried about her younger siblings much more then her. She could never over come these negative emotions. She had also made suicidal attempts in past due to the sour relationship with her parents. At present is staying with husband but due to her past experiences she is not able to trust anyone easily. She feels that husband has a extra marital affair. Even then never shares her feeling with him, keeps all these insecurities and negative emotions in her mind. At night time when she is about to sleep, her mind gets preoccupied with these thoughts and she gets sleepless. At 1.5 months follow up on 2 April 2011, Ms. R.P.P reported improvement in her sleep pattern, she would get sleep before the midnight. Her sleep was sound and there was improvement in her thought process. Her negative thoughts had also reduced. At 4 months months follow up on 2 July 2011, Ms. R.P.P reported slight increase in her sleeplessness. Her sleep was not sound again. On detailed questioning she mentioned about some differences with her husband which had become active again. Both husband and wife were counseled to discuss and sort out their differences. There were certain changes made in the medicines. At 6 months follow up on 5 September 2011, Ms. R.P.P reported improvement in her sleep. She could sleep well and there was improvement in the quality of her sleep. Her negative thoughts had almost reduced by 50 %. Since she was sleeping well, she would feel fresh during the day time and could do her daily activities quiet well. At 9 months follow up on 6 December 2011, Ms. R.P.P reported 50 % improvement in her sleep pattern. She was feeling more relaxed and feeling more positive about everything. She was also working on her strained relationship with her husband. At 12 months follow up on 23 April 2012, Ms. R.P.P reported very good improvement in her sleep pattern and there was also a positive change in her mind state. She was able to take the stress more positively and was working towards bringing about positive changes in her life. At 16 months follow up on 21 September 2012, Ms. R.P.P reported having normal sleep and there was no need to take any anxiolytic medications, she happily stopped the treatment. Uploaded by Dr. Z.A.R on 30 September 2012.