EENT and Sleep Disorders Q 3

---

A client has a diagnosis of primary insomnia. Before assessing this client, the nurse recalls the numerous causes of this disorder. Select all that apply.

  

     A. Chronic stress

     B. Severe anxiety

     C. Generalized pain

     D. Excessive caffeine

     E. Chronic depression

     F. Environmental noise

Correct Answers: A, D, and F

---

Insomnia is the most common sleep disorder in the United States affecting about one-third of the general population. According to the third edition of the International Classification of Sleep Disorders (ICSD-3), insomnia is characterized by difficulty in either initiating sleep, maintaining sleep continuity, or poor sleep quality.

---

Option A: Acute or primary insomnia is caused by emotional or physical discomfort not caused by the direct physiologic effects of a substance or a medical condition. Individuals who have difficulty coping with a stressful situation or those who report being habitual light sleepers have an elevated propensity to develop chronic insomnia.

Option B: There is a high rate of association between insomnia and psychiatric disorders like depression, anxiety, and post-traumatic stress disorder. Developmental issues during childhood, for example, separation anxiety, may predispose a child to develop sleep problems.

Option C: Comorbid medical issues like restless legs syndrome, chronic pain, gastroesophageal reflux disease (GERD), respiratory issues, and immobility are associated with the risk of chronic insomnia.

Option D: Excessive caffeine intake is an example of disruptive sleep hygiene; caffeine is a stimulant that inhibits sleep. Insomnia is prevalent in 10% to 15% of the general population. Roughly 5.5 million office visits related to sleep disturbances were reported in the United States in 2010.

Option E: People with certain personality traits like perfectionism, ambitiousness, neuroticism, low extraversion, and susceptibility to depression and worry are more likely to develop insomnia over time.

Option F: Environmental noise causes physical and/or emotional and therefore is related to primary insomnia. The client should be advised to restrict the maladaptive behaviors like eating or reading in bed, late-night use of digital devices in the bed, and go to bed to sleep only when feeling extremely sleepy.

---