Tuesday, December 7, 2021

The misdiagnosis of sleep disorders as mental illness

Home Forums Community The misdiagnosis of sleep disorders as mental illness

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    Case study: psychiatric misdiagnosis of non-24-hours sleep-wake schedule disorder resolved by melatonin.


    This case study describes a 14-year-old male suffering from significant academic and personal difficulties, who has been diagnosed with depression, schizotypal personality disorder, and learning disabilities. Because of excessive sleepiness, assessment for a potential sleep disorder was performed. An overnight polysomnographic study revealed no primary sleep disorders. Wrist actigraphy revealed a non-24-hour sleep-wake pattern. Delay in temperature rhythm and dissociation with melatonin rhythms were also noted. Treatment with oral melatonin restored normal sleep-wake schedule. In a follow-up psychiatric evaluation, none of the above diagnoses were present. Greater awareness of sleep disorders may prevent psychiatric misdiagnosis of treatable sleep-wake schedule disorders.

    Here is the description of his case before proper diagnosis and treatment:




    Thank you so much for this post as you have given me an idea about getting help for a mysterious sleep disorder that I have. I have been diagnosed with sleep apnea but I still have another issue that no sleep physician has been able to solve as I have sleep attacks usually in the afternoon due to what I feel is a misaligned circadian clock since I wake up early in the morning. I am going to ask my sleep physician to see if she feels using actigraphy like what was used with this kid would help. She is open to ideas as an FYI.

    I suppose I could experiment with the melatonin myself but I have had rotten luck with it. So it would be nice if I could see exactly what is going on with my sleep pattern.

    Back to your point – yes, many people who have sleep disorders have been misdiagnosed as having psych issues. I can’t blame my psychiatrist because sleep disorders weren’t very well known when I was on psych meds. But any psychiatrist or mental health professional who doesn’t screen their patients for sleep disorders and continues to the BS that resolving the mental health issue will resolve sleep is committing big time malpractice in my opinion.


    Sleep attacks, that sounds like narcolepsy to me. From what I have read most people don’t respond well to melatonin but something tells me that an unusual circadian rhythm means one should take their melatonin at an usual time. I’m thinking there’s probably a very specific time for each individual when taking the melatonin would be successful, but wouldn’t be successful if taken at any other time. Just a thought, I’m sure I have no idea what I’m talking about!

    Here is more information about actigraphy

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