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

Yaron Dagan, Liat Ayalon

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1271-1275
Number of pages5
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume44
Issue number12
DOIs
StatePublished - Dec 2005
Externally publishedYes

Bibliographical note

Funding Information:
Supported by NIMH 5 T32 MH18,399-17, M01 RR00,827 (L.A.).

Keywords

  • Actigraphy
  • Circadian rhythm sleep disorder
  • Free running
  • Melatonin
  • Non-24-hour sleep-wake syndrome

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