title: Insomnia treatment by olanzapine. Is sleep state misperception a psychotic disorder?
abstract: Offering a new perspective on sleep state misperception, we discuss a patient who presented with sleep state misperception and was ultimately diagnosed with delusional disorder. A 60-year-old woman with chief complaints of insomnia, agitation, and suicidal ideation, was admitted to an inpatient psychiatric ward. Based on information from her family and a mental state examination, her primary diagnosis was sleep state misperception. She was treated with Trazodone. Because she was unresponsive to the treatment, a full psychiatric evaluation and wrist actigraphy report were undertaken, resulting in a revised diagnosis of delusional disorder. She was started on Olanzapine and, after 6 weeks was discharged with good improvement. Sleep state misperception might be considered not just as a sleep disorder, but also as a psychiatric disorder with psychotic symptoms. Further research is recommended.
authors.affiliation: Sleep Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran. ha_khazaie@yahoo.com
authors.forename: Habibolah
authors.initials: H
authors.lastname: Khazaie
authors.forename: Leeba
authors.initials: L
authors.lastname: Rezaie
authors.forename: Masoud
authors.initials: M
authors.lastname: Tahmasian
authors.forename: David C
authors.initials: DC
authors.lastname: Schwebel
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000077152:Olanzapine; D011618:Psychotic Disorders / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine