Dados do Trabalho

Título

The emerging use of actigraphy in psychiatric disorders : case report

Introdução

Actigraphy is a validated method to measure objective sleep parameters and activity, which provide rest-activity patterns able to predict circadian rhythm disorders, sleep deprivation, evaluate sleepiness during the day and speculate about behaviors related to insomnia. Literature regarding the use of actigraphy in psychiatric disorders is growing fast. Its use can range from the evaluation of 24h activity periods, including information about sleep, to the characterization of “energy periods”.

Objetivo

To demonstrate the importance of actigraphy in the management of a patient with Munchausen Syndrome.

Métodos

Anamnesis, physical examination and actigraphy were performed.

Resultados

We report here a 38-year-old female patient, wheelchair user since 2011, complaining of difficulty to initiate and mantain sleep and early awakenings for five years. In addition twice a week she spends the whole night awake. Despite the sleep deprivation she has a restorative sleep. She denied sleep fragmentation and sleepiness during the day. In the consultation, the electronic medical record was assessed and surprisingly the patient had a previous diagnosis of Munchausen Syndrome. Considering this diagnosis, not reported by the patient, we prescribed filling out sleep logs and the use of actigraphy to understand her 24-hour rhythym. Her sleep logs did not provide the desired information, but actigraphy showed a shortened total sleep time and a low activity pattern during the day representing a flattened biological rhythm.

Conclusões

Some psychiatric disorders, such as Munchausen Sindrome, limit patients’ ability to provide accurate information regarding sleep patterns which could lead to an incorrect diagnosis and consequently an inaproppriate treatment. The use of an objective method, like actigraphy, to precisely report activity patterns is necessary and useful to determine the rest-activity cycles, thereby helping to determine the correct diagnosis and to adequately manage the treatment.

Palavras-chave

actigraphy,Munchausen Sindrome, psychiatric disorders,insomnia.