"There are two questions associated with this case." "Insomnia-Fatigue Case 2."
A regular patron of the grocery store pharmacy comes to pick up his monthly refill for temazepam (Restoril), which is a long-acting benzodiazepine. He also wants to ring out a 4-pack of Corona Light and 4 sugar-free Red Bulls. He seems out of it - you ask him for his birthday multiple times and each time he gives you his address Question 1 of 2: Which of the following causes of daytime sleepiness can be treated with self-care measures like drinking a Red Bull?

A. Contact lens storage cases should be replaced every 3 months: Regular replacement of lens cases prevents microbial contamination, including bacteria and fungi, which can cause keratitis or other serious eye infections. Over time, biofilm can accumulate in cases even with routine cleaning, so replacing them quarterly is a key preventive measure.

B. Dispose of used contact solution daily: Reusing old or contaminated solution can introduce pathogens to the eye. Daily disposal ensures lenses are stored in fresh, sterile solution, reducing the risk of microbial keratitis, conjunctivitis, or corneal ulceration.

C. Remove lenses prior to using ocular medications: Administering eye drops over lenses can alter drug absorption, reduce efficacy, and increase risk of lens contamination. Removing lenses first ensures the medication reaches the cornea directly and prevents potential damage to the lenses.

D. All of the above: All listed measures collectively promote safe contact lens use by reducing infection risk, ensuring proper medication delivery, and maintaining lens hygiene. Each component is an essential part of evidence-based contact lens care practices.

A. More information is needed: The client’s case provides limited data, there is insufficient detail about sleep onset, duration, nighttime awakenings, or associated symptoms such as cataplexy, sleep paralysis, or other systemic conditions. Accurate diagnosis of a sleep disorder requires a comprehensive sleep history, possibly including a sleep diary, polysomnography, and assessment of contributing medical or psychiatric conditions.

B. Chronic insomnia: Chronic insomnia is characterized by difficulty falling asleep, staying asleep, or early morning awakenings for at least three nights per week over three months, with resulting daytime impairment. The client’s symptoms focus on daytime napping without clear nighttime sleep difficulties, so chronic insomnia cannot be confirmed.

C. Narcolepsy: Narcolepsy involves excessive daytime sleepiness, cataplexy, sleep paralysis, or hallucinations at sleep onset. While the client has daytime sleepiness, there is no information about sudden sleep attacks, cataplexy, or other hallmark narcolepsy features, making this diagnosis premature.

D. Chronic fatigue: Chronic fatigue is a persistent state of physical and mental exhaustion lasting six months or longer, often associated with other systemic symptoms. The client reports acute sleepiness and naps but lacks the broader systemic context to diagnose chronic fatigue syndrome.