Multiple sleep pathologies presenting as depression.

Successful management of patients with sleep disorders requires attention to the clinical history, particularly the sleep history, knowledge of the causes of insomnia and hypersomnia, and familiarity with a variety of therapeutic interventions. To illustrate these principles, the authors describe a 68-year-old woman who had a history of clinical depression but who, on further investigation, was found to suffer from three sleep disorders: narcolepsy, periodic leg movements during sleep, and rapid eye movement sleep behaviour disorder. Treatment of these sleep disorders caused a complete amelioration of the mood symptoms and a significant improvement in psychosocial functioning and well-being.