Misdiagnosis of Sleep disorders
Alternative diagnoses list for Sleep disorders:
For a diagnosis of Sleep disorders,
the following list of conditions
have been mentioned in sources
as possible alternative diagnoses
to consider during the diagnostic process for Sleep disorders:
Diseases for which Sleep disorders may be an alternative diagnosis
The other diseases for which Sleep disorders
is listed as a possible alternative
diagnosis in their lists include:
Rare Types of Sleep disorders:
Sleep disorders: Medical Mistakes
Related medical mistakes may include:
Common Misdiagnoses and Sleep disorders
Mild worm infections undiagnosed in children: Human worm infestations, esp. threadworm, can be overlooked in some cases,
because it may cause only mild or even absent symptoms.
Although the most common symptoms are anal itch (or vaginal itch),
which are obvious in severe cases,
milder conditions may fail to be noticed in children.
In particular, it may interfere with the child's good night's sleep.
Threadworm is a condition to consider in children with symptoms such as bedwetting (enuresis),
difficulty sleeping, irritability, or other sleeping symptoms.
Visual inspection of the region can often see the threadworms, at night when they are active,
but they can also be missed this way, and multiple inspections can be warranted if worms are suspected.
See the introduction to threadworm.
Insidious cancer misdiagnosed as mental health condition: Pancreatic cancer is fortunately relatively rare,
but this dangerous condition can be misdiagnosed as a mental condition in its
Psychological symptoms similar to depression are common (including suicidal symptoms),
leading to possible misdiagnoses of depression.
Patients also often have difficulty sleeping leading to a misdiagnosis of insomnia (particularly
with difficulty falling asleep),
or some sleeping disorder, including the revere symptoms of excessive sleeping (hypersomnia).
See the overview of pancreatic cancer.
RLS sleep disorder causing night-time leg sensations often misdiagnosed: A common but relatively unknown
sleep-related disorder called Restless Leg Syndrome (RLS) is often misdiagnosed.
The typical symptoms are night-time tingling, crawling, or burning sensations in the legs,
with the irresistable urge to move the legs.
This need for leg movement leads to tossing and turning, or getting up out of bed,
all of which interferes with the ability to fall asleep.
The sufferer then has the typical symptoms of sleep deprivation during the day: fatigue, tiredness,
morning headaches, irritability, poor concentration and so on.
This condition is sometimes misdiagnosed as other conditions
such as ADHD, sleep disorders, other causes of insomnia, or other causes of leg tingling.
Many patients also suffer from a related disorder called
Periodic limb movement disorder (PLMD), which causes leg spasms
or other jerky movements.
See introduction to RLS or introduction to PLMD.
Failure To Diagnose Sleep disorders
Failure to diagnose Sleep disorders may be associated with the following:
- Sleeping disorders often remain undiagnosed because patients are hesitant to bring up sleeping problems with their doctor in case it appears trivial or they may fear it is a sign of a serious illness. Also, symptoms of sleeping problems that are volunteered by patients are often ignored by physicians, especially if the patient is seeing the doctor for other problems as well. Patients and doctors often believe that sleeping problems will resolve spontaneously with time
- Often sleeping problems may be better described by a bed partner than the patient as often they are unaware of their symptoms while sleeping. Symptoms that may not be noticed by the patient but may be reported by a bed partner includes snoring, grinding teeth, periods of breathing cessation and sleep walking. An accurate description of sleeping habits is vital for a correct diagnosis
- Undiagnosed sleep disorders can lead to various complications depending on the type, severity and duration of the sleep disorder. Complications include: irritability, depression, increased risk of diabetes, cardiovascular disease, stroke and vehicle accidents as well as impaired thinking, concentration and memory and a reduced sex drive. Some studies indicate that chronic sleeping problems can result in a weakened immune system
- Sleeping disorders are underdiagnosed due to the false belief (by patients and many physicians) that they are generally harmless. Also, the limited session times in a physician's office often means that difficult to diagnose conditions such as sleeping disorders are often neglected due to time constraints. Diagnosing a sleep disorder is often a lengthy process. Furthermore, many physicians have inadequate knowledge to accurately diagnose sleeping disorders - especially since there are so many of them and the list of possible causes is extensive.
- Busy physicians are more likely to take a generalized approach to sleeping complaints and offer a prescription for medication that induces sleep rather than investigating further to determine the real cause of the sleeping problem
- A large portion of the population has undiagnosed sleeping disorders. Often patients try to manage their symptoms themselves through altering sleep routines or medications. An accurate diagnosis can better enable a patient to manage their condition
- Women are less likely than men to acknowledge the symptoms of a sleep disorder and to seek medical advice. Women also have additional sleep problems to men related to hormonal changes that result from pregnancy, menopause and even menstruation. Women also tend to respond differently to insomnia than men, women will keep going no matter how tired they get whereas men are more likely to increase their sleeping time if they are feeling tired. Women are also more likely to use caffeinated drinks and food to bolster their energy when they feel tired. Studies indicate that more women suffer from insomnia than men but it is generally believed to be more common in men
- Sleep disorders are often considered relatively harmless but long-term sleep deprivation can have a significant impact on a person's physical, social and mental health
- One of the tests used to diagnose some sleep disorders is a polysomnography but experts claim that these tests are not readily available to many people. The test is also very expensive so health professionals hesitate in recommending it unless they are reasonably sure the patient has a serious sleep disorder. Also, patients often can't be bothered with going through the lengthy process of a sleep study
- Misdiagnosis of sleep apnea and undiagnosed sleep apnea is more common in women possibly due to the fact that women tend to focus on different symptoms when reporting their condition to a health professional. For example, women tend to report fatigue, insomnia, use of sleeping medication and tension which often points to a diagnosis of depression. Men however are more likely to report the classic symptoms of sleep apnea such as snoring, waking up choking and sleepiness during the day
Notes On Hidden Causes Of Sleep disorders
The following may be hidden causes of Sleep disorders:
- Sleeping problems may be associated with conditions such as anxiety, panic, depression, mood disorders, schizophrenia and psychoses
- There are numerous possible causes of sleeping problems: life-style changes, shift-work, chronic pain, stress, sciatica, back pain, anxiety, neck pain, poor bedtime habits, incontinence, environmental noise, certain drugs, illness, endocrine imbalance and chronobiological disorders
- Smoking, alcohol, room temperature, respiratory muscle weakness may also affect quality of sleep
- Infants born prematurely are at a greater risk of sleep disorders
- Narcolepsy is one of the few sleep disorders that may be inherited
- Craniofacial structural anomalies may cause sleeping disorders (particularly obstructive sleep apnea). Examples include, small jaw, recessed jaw, underdeveloped upper jaw, cleft palate, large tongue, deviated septum, narrow nasal passage, enlarged adenoids, nasal polyps, nasal mass and enlarged tonsils
- Breathing difficulties such as asthma, coughing, hayfever and other allergies may cause insomnia
Notes On Wrong Diagnosis Of Sleep disorders
Wrong diagnosis of Sleep disorders may be associated with the following:
- Sleep disorders may be hard to diagnose as the common symptom is generally daytime tiredness. Investigating the possible causes of sleeping problems enables the specific sleep disorder to be pinpointed
- Patients who don't inform their health physician about smoking habits and alcohol and medication use, take the risk of having their sleeping disorder wrongly diagnosed or having to undergo unnecessary testing. For example, a patient complaining of daytime sleepiness may undergo a sleep study when their problem is actually caused by a medication which causes insomnia
- Deep sleep phase syndrome is a commonly misdiagnosed sleep disorder and is often diagnosed as a primary psychiatric disorder such as depression, psychophysiological insomnia, psychiatric disorders (schizophrenia, ADHD, ADD) or other sleep disorders
- Sometimes sleep disorders are misdiagnosed when the patient fails to accurately describe their symptoms. For example, a patient complaining of the inability to get to sleep at a reasonable hour but stays asleep for a normal length of time may have a different sleeping disorder to someone who is unable to get to sleep at a decent time but then also wakes frequently
- Delayed sleep phase syndrome may be misdiagnosed as ADHD as sufferers tend to exhibit common symptoms such as going to bed late and problems with learning, memory, concentration, thinking and behaviour
- Patients with underlying psychiatric disorders will often present only the sleeping problem symptoms and will be unaware or unwilling to volunteer any symptoms that may point to a psychiatric disorder such as schizophrenia or depression
- Sometimes sleep disorders co-exist (e.g. sleep apnea and restless leg syndrome) which can make diagnosis more difficult
- Insomnia may also be misdiagnosed as anemia or a thyroid. Insomnia symptoms may sometimes be dismissed simply as laziness
- Patients with night terrors are often misdiagnosed as having post traumatic stress disorder or simply as nightmares
- Symptoms of sleep apnea in patients with end-stage renal disease are often ignored or misdiagnosed as depression, uremia or insomnia. Often symptoms are simply considered to be side-effects of the kidney condition. Sleep apnea patients diagnosed with insomnia and treated with sedatives may exacerbate the sleeping problems which can cause an overall deterioration in health, especially for end-stage renak disease patients
Complications Of Misdiagnosis Of Sleep disorders
The following may be complications of misdiagnosis of Sleep disorders:
- Speech problems resulting from obstructive sleep apnea may be misdiagnosed simply as a speech problem rather than the complication of a primary sleep disorder
- Sleep disorders can cause symptoms such as depression, irritability, reduced sex drive and poor concentration, memory and cognitive functioning which may be dismissed as the result of life stresses or simply diagnosed as depression
- Sleep disorders such as restless leg syndrome may be misdiagnosed with restless leg syndrome, especially in children
- Delayed sleep-phase insomnia may be misdiagnosed as another sleep disorder - primary insomnia.
- Changes in sleep cycles are often a normal part of aging but this may be misdiagnosed as a sleep disorder which leads to unnecessary treatment
- Teenagers and children often need more sleep than adults. So teenagers and children who are tired during the day and who appear lazy, irritable, and moody or don't perform as well at school as expected often have their symptoms put down the hormonal changes or normal childhood tiredness rather than considering a sleep disorder as a possible cause
- Chronic sleep problems caused by a mild brain injury may be misdiagnosed as a sleep disorder. Treatment will only mask the symptoms and not treat the underlying brain injury. The treatment may also exacerbate the brain injury symptoms (e.g. headache and cognitive impairment)
- Sleep disorders such as insomnia in older patients may also mimic dementia. Common symptoms include impaired cognitive function and memory and mood changes
Medical news summaries about misdiagnosis of Sleep disorders:
The following medical news items
are relevant to misdiagnosis of Sleep disorders:
General Misdiagnosis Articles
Read these general articles with an overview of misdiagnosis issues.
When checking for a misdiagnosis of Sleep disorders
or confirming a diagnosis of Sleep disorders,
it is useful to consider what other
medical conditions might be possible misdiagnoses or other alternative
conditions relevant to diagnosis.
These alternate diagnoses of Sleep disorders may already have
been considered by your doctor or may need to be considered as possible
alternative diagnoses or candidates for misdiagnosis of Sleep disorders.
For a general overview of misdiagnosis issues for all diseases,
see Overview of Misdiagnosis.
» Next page: Undiagnosed Sleep disorders
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