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Differential Diagnosis of Sleep Paralysis 

Differential Diagnosis of Sleep Paralysis
Differential Diagnosis of Sleep Paralysis

Brian A. Sharpless

and Karl Doghramji

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date: 19 September 2020

Given the unusual nature of characteristic symptomatology and the fact that the phenomenon is relatively unknown, diagnosis of sleep paralysis and isolated sleep paralysis can be challenging. After a more general discussion of the factors leading to potential misdiagnoses, the chapter provides guidance in differentiating sleep paralysis from other, better-known conditions. First, it demonstrates diagnostic differences between sleep paralysis and other sleep disorders (e.g., Nighmare disorder, sleep terrors). Next, sleep paralysis is differentiated from psychotic and other major mental health diagnoses (e.g., symptomatology of post-traumatic stress disorder; conversion disorder). Third, it discusses diagnostic differences between sleep paralysis, cataplexy, familial periodic paralysis, and other medical conditions. Finally, it discusses potential challenges to diagnosis when sleep paralysis episodes are interpreted as actual assaults as opposed to unusual nocturnal experiences.

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