NURS 6630 Sleep-Wake Disorders Case Study Assignment Guide
Half the marks on each page are for the two options you rejected — and the introduction's job is to supply the patient factors that make those rejections arguable.
Editorial process
Last reviewed · August 9, 2026
Five pages, allocated for you
This brief allocates its pages explicitly and that allocation is the plan: one page introducing the case, then one page per decision, across five pages. Follow it literally. The introduction is not scene-setting — the brief asks specifically for the *patient factors that may impact your decision making when prescribing*, which means it is where you establish the constraints the next three pages operate under. Age, comorbidities, concurrent medications, occupation, driving, substance use, and anything affecting absorption, metabolism or clearance all belong there, and each one you name is a criterion you can hold the three decisions to. A page of general description of insomnia is the commonest way to lose the introduction, since it uses the space without producing a single constraint the later decisions can be judged against. Write the introduction last if that is easier, since the factors worth naming are the ones your three decisions turned out to depend on.
What distinguishes this decision tree from others in the course is a requirement most students under-answer: at every decision point you must say **why you did not select the other two options**, with clinically relevant, patient-specific support from the primary literature. That is half the marks on each page and it is not satisfied by a sentence. Treat each rejection as a small argument — what the option would have done, what property of this patient makes it unsuitable, and what evidence supports that judgement. Two rejections done properly are usually longer than the selection itself. The instruction to research each option *before* deciding is worth taking literally, because a rejection reasoned backwards from a choice already made tends to be the weakest paragraph on the page. Keep the rejections specific to the same patient rather than general drug criticism, because an argument that a drug is unsuitable in principle does not explain why it is unsuitable here.
The pharmacology here is unusually well suited to patient-specific argument, so use it. Agents for insomnia differ in half-life, in receptor selectivity, in whether they help with sleep onset or sleep maintenance, in dependence and tolerance liability, and in next-day residual effects — and that last one is where the patient factors from your introduction earn their place. A long half-life in a patient who drives to work at six in the morning is a different proposition from the same drug in someone who does not. Sleep-onset difficulty and middle-of-the-night waking call for different agents, and saying which the case describes is the first discriminating move available. Name the pharmacokinetic property you are relying on each time, since the brief asks you to consider factors affecting pharmacokinetic and pharmacodynamic processes and a rationale without a mechanism does not address that.
There is also a point about scope that a strong paper makes early. Pharmacotherapy is what this assignment asks you to reason about, but insomnia has a first-line non-pharmacological treatment with a substantial evidence base, and acknowledging that in a sentence — while proceeding with the prescribing exercise the assignment sets — demonstrates clinical judgement rather than departing from the brief. It also strengthens the ethics section, since the existence of an effective non-drug option is directly relevant to informed consent. Keep it brief and do not let it displace the pharmacology, because the assignment is explicit that you are making three medication decisions and the marks sit there. Placing it in the introduction rather than in a decision paragraph is usually cleanest, since that is where the treatment context belongs and it leaves the decision pages for the prescribing argument.
The ethics element appears under Decision One rather than at the end, and it asks how ethical considerations may impact your treatment plan *and communication with patients*, with examples. For hypnotic prescribing the specific issues are concrete: informed consent about dependence and tolerance, next-day impairment and its implications for driving and work, expectations about duration of use, and how you would explain that a medication intended to be short-term often is not. Generic paragraphs on autonomy and beneficence do not answer this; named examples do. Say what you would tell the patient in words you would actually use, since the brief asks for examples and a quoted sentence of counselling is the clearest kind of example available. Ethical considerations also reach the patient's driving and work, so link the counselling back to the residual-effect evidence you used in the prescribing rationale rather than treating them as separate topics.
On mechanics: five pages with the internal allocation stated, and a repeated instruction to support your reasoning with the *primary literature*, which excludes reviews and textbooks as the sole basis. That is the most checkable requirement in the brief, so make sure that at least some citations are trials or original studies rather than secondary summaries. The expected results and the comparison with actual outcomes follow the same structure at each decision point. Distribute the citations across all three decisions and both rejections at each, because a paper with eight sources clustered in Decision One and none in Decision Three has failed the requirement in the place it is most visible. Read the case again after drafting and check that each decision used something the previous outcome supplied, since a decision tree whose branches do not respond to their results has been written as three independent answers.
Element | The version that loses marks | The version that scores |
|---|---|---|
Introduction | A page about insomnia | Patient factors that constrain the decisions |
Page allocation | Improvised | One page introduction, one per decision |
Rejected options | A sentence each | An argument each, with patient-specific evidence |
Research order | Chosen first, justified after | Each option researched before deciding |
Drug choice | Named | Named with the property that fits this patient |
Half-life | Not mentioned | Tied to the patient's morning obligations |
Onset vs maintenance | Undifferentiated | Matched to what the case describes |
Non-drug treatment | Ignored, or takes over | Acknowledged in a sentence |
Ethics | Autonomy and beneficence | Dependence, next-day impairment, duration of use |
Literature | Reviews and textbooks | Primary studies, spread across all decisions |
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Establish patient factors that constrain every subsequent prescribing decision.
- 02Argue the rejection of unselected options as fully as the selection.
- 03Match hypnotic properties to a patient's daily obligations.
- 04Address hypnotic-specific ethical issues with named examples.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
Important information for writing discussion questions and participation Hi Class, Please read through the following information on writing a Discussion question response and participation posts. Contact me if you have any questions. Important information on Writing a Discussion Question Your response needs to be a minimum of 150 words (not including your list of references) There needs to be at least TWO references with ONE being a peer reviewed professional journal article. Include in-text citations in your response Do not include quotes—instead summarize and paraphrase the information Follow APA-7th edition Points will be deducted if the above is not followed Participation –replies to your classmates or instructor A minimum of 6 responses per week, on at least 3 days of the week. Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article Each response needs to be at least 75 words in length (does not include your list of references) Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count. Follow APA 7th edition Points will be deducted if the above is not followed Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points. Here are some helpful links Student paper example Citing Sources The Writing Center is a great resource Welcome to class Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to. I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you. Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. 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A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
What each page must contain
- 01A five-page paper following the stated page allocation.
- 02A one-page introduction with the patient factors affecting prescribing.
- 03Decision #1 with the choice, the rationale, the two rejections and the aim.
- 04An ethics discussion covering the treatment plan and patient communication.
- 05Decision #2 and Decision #3 in the same structure.
- 06Support from the primary literature throughout.
From the patient factors to Decision Three
The patient, not the condition
Establish the factors that constrain prescribing for this case.
Decision One
Choose, justify, reject the alternatives, and state the aim.
Ethics and communication
Address dependence, impairment and expectations with examples.
Decision Two
Respond to the case outcome with a new set of rejections.
Decision Three
Justify the final position against both alternatives.
Primary literature, not reviews
Recommended databases
- PubMed Central
- Journal of Clinical Sleep Medicine
- Walden Library
- Sleep and psychopharmacology journals
Search sequence
- 1.Search for primary trials rather than reviews, since the brief names the primary literature explicitly and that is the most checkable requirement in it.
- 2.Find comparative evidence on hypnotic half-life and next-day residual effects, which is where a patient factor from the introduction becomes a prescribing argument.
- 3.Look for studies distinguishing sleep-onset from sleep-maintenance treatment, so the choice matches what the case actually describes.
- 4.Search for evidence on dependence, tolerance and duration of use, which is what turns the ethics section from principles into counselling content.
Hypnotic options, residual effects and real-world use
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians
International Journal of Molecular Sciences · 2015
Sets out how the available agents differ in mechanism and duration of action, which is the material each decision's rationale and each rejection needs.
- 02
Residual effects of zopiclone 7.5 mg on highway driving performance in insomnia patients and healthy controls
Psychopharmacology · 2014
Primary evidence on next-day impairment, which is exactly the patient-specific argument that turns a half-life into a reason to reject an option.
- 03
Gender Differences in the Efficacy and Safety of Chronic Nightly Zolpidem
Journal of Clinical Sleep Medicine · 2016
A patient-factor difference with dosing consequences, useful for demonstrating that the introduction's factors genuinely change the prescribing decision.
- 04
Middle-of-the-night hypnotic use in a large national health plan
Journal of Clinical Sleep Medicine · 2013
Evidence on real-world use patterns, which supports the ethics section's point about how long short-term prescribing actually lasts.
Before the assignment is submitted
Common mistakes
- Spending the introduction describing insomnia rather than the patient.
- Producing no constraints the later decisions can be judged against.
- Dismissing the two unselected options in a sentence each.
- Reasoning the rejections backwards from a choice already made.
- Naming a drug without the property that suits this patient.
- Ignoring half-life and next-day residual effects.
- Failing to distinguish sleep-onset from sleep-maintenance difficulty.
- Omitting any mention of non-pharmacological first-line treatment.
- Letting the non-drug discussion displace the prescribing exercise.
- Answering the ethics element with autonomy and beneficence.
- Citing only reviews and textbooks when primary literature is required.
- Clustering all citations in Decision One.
Submission checklist
- The paper follows the one-plus-three page allocation.
- The introduction names specific patient factors.
- Each decision states the choice and its rationale.
- Each decision explains why both other options were rejected.
- Rejections carry patient-specific evidence.
- At least one pharmacokinetic property is named per decision.
- Next-day residual effects are addressed against the patient's obligations.
- Non-pharmacological treatment is acknowledged.
- Ethics covers dependence, impairment and duration of use with examples.
- Primary studies appear across all three decisions.
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Written by
Aaron Bishop
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