Understanding Distinct Differences in Sleep Disorders to Ensure Accurate Diagnosis: Alcibiades J. Rodriguez, MD


The director of the Comprehensive Epilepsy Center—Sleep Center at NYU Langone provided perspective on the overlap in characteristics of sleep disorders and the necessary approach to ensuring accurate diagnosis and initial treatment. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"We start breaking down the daily patterns, nighttime patterns, and we try to find common ground. As you said, there could be a significant overlap in the diagnosis. For the patient, we need to educate them on what these mean because they may think ‘I don’t sleep well and stay awake at night so I have sleep apnea.’ Well, you may have sleep apnea but that particular condition you’re describing is insomnia."

The recognition and diagnosis of sleep disorders can be particularly tricky, considering some may appear like others as well as overlap at the same time. In addition, psychiatric disorders and sleep dysfunction have been shown to be correlated. Insomnia, fatigue, and sleep changes can be diagnostic in mood, anxiety, and neurodevelopmental disorders, while sleep disorders may present with significant neuropsychiatric symptomatology.1 Over the years, research has backed the thought that sleep and wakefulness are essential functions of the brain, and at times, can have significant impacts on the quality of life for an individual.

There are several different neurological conditions that interfere with this function, causing disruption of normal sleep patterns. These include central nervous system hypersomnia, narcolepsy, central sleep apnea, REM sleep behavior disorders, parasomnias, circadian rhythm disorders, and fatal familial insomnia. Identifying these may be difficult, but there are certain key traits to look out for and questions that can lead to successful diagnosis, says Alcibiades Rodriguez, MD.

Rodriguez, director of the Comprehensive Epilepsy Center—Sleep Center at NYU Langone, recently sat down with NeurologyLive® to talk about the steps and conversations that lead up to diagnosis, and what clinicians should be mindful of with presenting patients. He discussed some of the differences in sleep disorders and where overlap may occur. In addition, he spoke on some of the lesser known conditions that are not as prevalent but could have impact on treatment decisions.

1. Rao N. The overlap between sleep disorders and psychiatric disorders. Sleep Med and Mental Health. Published online July 23, 2020. Accessed February 26, 2024. doi:10.1007/978-3-030-44447-1_17
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