45 minute intruder full#

Generalized anxiety disorder 7-item scale (GAD-7) score was 11 (indicative of probable anxiety disorder). His Epworth Sleepiness Scale score was 14/24 and Patient Health Questionnaire (PHQ-9) score was 5 (indicative of mild depression). He had a Mallampati class II airway and a neck circumference of 15.5 inches. His mother had similar symptoms during adulthood, and has a concomitant diagnosis of anxiety. Additional factors which reduce the severity/frequency of the episodes include the presence of his wife and family at home, incorporation of relaxation techniques, medication, and completing all work duties by 8 P.M. The use of this medication seems to lessen the likelihood of his nocturnal events. The patient's medications include alprazolam for sleep, used as needed. The patient has no significant past medical history. He also has had more recent issues with insomnia after he heard that symptoms similar to this can be related to a neurodegenerative disease.Ī questionnaire completed by his bed partner noted nightly awakenings 45 minutes after falling asleep with intense anxiety/dread, often with voiced concerns that he is choking or that there is an intruder in the house. The events will increase to as many as 3–4 times a night if he sleeps away from home.

The frequency of the episodes is once per night when sleeping at home, occurring mostly during the second part of the night.

45 minute intruder full#

He has full memory of these events and is generally able to fall asleep shortly after awakening. The patient describes episodes of “waking up suddenly with a concern of a noise in the house, or intruder,” associated with a “sense of choking.” Sometimes he feels that he is in a falling elevator, another treacherous environment, or threatening situation where he “loses control.” These events are temporally associated with episodes of racing heart rate, chest discomfort, and a sense of impending doom. A 36-year-old male presented for evaluation of bothersome nighttime awakenings since age 18.