Insomnia related to anxiety Sleep disturbance related to anxiety
Encourage a diary of her episodes of insomnia and anxiety: stating associated factors and what helps with the anxiety Offer cognitive behavioral therapy (CBT) Educate on anxiety reduction strageties including deep breating, relaxation and guided imagery. Offer consultation to behavioral Health Specialist Encourage diet and exercise regimin Decrease caffeine intake Offer telephone appointment to check in with her in a week Give warning signs on when to seek for help, as in inability to care for self, depression, anxiety or sucidal ithoughts.
• Encourage Ms. Jones to continue to monitor symptoms and log episodes of insomnia and anxiety with associated factors and br log to next visit. • Encourage to decrease caffeine consumption and increase inta of water and other fluids. • Educate on anxiety reduction strategies including deep breathin relaxation, and guided imagery. Continue to monitor and explore need for possible referral to social work/psychiatry or pharmacol intervention. • Discuss need to maintain regular sleep and wake schedule and sleep hygiene techniques including limiting caffeine after 2pm, limiting fluids after dinner, limiting screen time or stimulating activities after 8pm, and to get out of bed if awaken in the middle the night. • Educate to limit alcohol and depressant medications (including diphenhydramine and Tylenol PM). • Educate on when to seek further or emergent care including feelings of self-harm or hopelessness. • Revisit clinic in 2-4 weeks for follow up and evaluation.
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