Susan Homfrey Asthma Case Study

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Thank you for referring Susan Humfrey, a 39-year-old part-time primary school teacher who also works as a bookkeeper for a family business. Susan is the mother of two children under the age of three years, a non-smoker and seldom consumes alcohol. Regular medications are sertraline that she has taken for the last three months and prior to that she was taking Cymbolta intermittently for 15 months, having had a four-month period off it. She takes the contraceptive pill and Uramine?? prn that she says is to promote alertness. There is a history of asthma with triggers including cold air, exercise, pollens and perfumes, but generally this does not give her trouble. She uses Ventolin prn.

Concerning her sleep, Susan often retires to bed at around 10.30pm, but reports sleep onset difficulties in the order on one hour. She will then use her smart phone and then within a few minutes can fall asleep. She wakes again at 2.00-2.30am for no specific reason and it may take her another 30-60 minutes to fall back to sleep. There is no history of snoring or witnessed apnoeas. There is a history of sleep paralysis and what sound like intermittent
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I suspect her sleep onset difficulties relate more to the fact that she does nap during the day and she will also inadvertently fall asleep for half an hour at round 8.00pm when reading to her children. Two conditions that I think we need to be suspicious for are narcolepsy and idiopathic hypersomnia. Susan reports a reasonable mood at present. She will proceed to having some routine pathology including a check of thyroid function and iron studies. She will also undergo a diagnostic sleep study combined with a multiple sleep latency test. It is imperative that Susan take very strict precautions when driving whilst we are attending to these issues. I will see her again shortly once the results are available and will update you

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