Unhealthy Somno Case Study

Thank you for referring Kori Stankovic, a 24 year-old software installer who is non-smoker, consumes alcohol on average a couple of standard drinks every couple of days and does not engage in any recreational drug use. Kori does not take any regular medication.

Unfortunately the referral letter was not available at the time of review however I gather the reason for referral is that Kori has been suffering with sleep onset insomnia and unrefreshing sleep. He usually retires to bed at 10.30pm but will generally not be able to sleep for at least an hour. On occasions he will then listen to some soft music and then make another attempt to fall asleep. Often he does not fall asleep until 1.30am to 2.00am. There is no history or snoring, witness apnoeas or nocturnal choking episodes but Kori's sleep is fragmented but there is no sleep maintenance insomnia. He reports general restless but no specific restless legs symptoms as such. When he awakes at 7.00am, he consistently feels unfreshed and he is aware of some daytime somnolence although the Epworth Sleepiness score is normal at 7/24. Kori has never experienced a microsleep when driving. He avoids daytime naps and he does not regularly consume caffeine. There are no features to suggest narcolepsy.

LFTs reveal an elevated ALT of 102, AST 838 and gamma GT 56. Viral hepatitis serology is negative. Fasting glucose and cholesterol are slightly