Malingering and Addiction in the Treatment of Sleep Disorders

Malingering and Addiction in the Treatment of Sleep Disorders

Sleep disorders

Sleep disorders are among the commonly experienced mental health problems. Examples include insomnia, and sleep apnea. Such illnesses make it difficult for the affected people to sleep well. The conditions can be treated by certain drugs that are used to induce sleep. These drugs are sometimes misused and abused due to their benefits. With time, this leads to addiction and malingering. The current essay describes various types of sleep disorder drugs, and it explains the potential addiction associated with them. The essay also describes malingering issues in the treatment of sleep disorders, and it examines the role of a mental health professional in mitigating malingering potentials.

Major Types of Drugs Prescribed for Sleep Disorders

There are five major drugs that are commonly prescribed for sleep disorders: “Z” sedative-hypnotics, benzodiazepines, dual orexin receptor antagonists, melatonin receptor agonists, and antidepressants. “Z” sedative-hypnotics help to improve sleep onset and its duration through inhibition of brain activity. They serve as facilitators of the GABAA receptor within the central nervous system of the human body (Preston et al., 2017). Examples include zaleplon, zolpidem, and eszopiclone.  Benzodiazepines help to raise the level of the GABA neurotransmitter within the brain (Fuermaier et al., 2014). Examples include lorazepam, and temazepam. Dual orexin receptor antagonists inhibit the orexin receptor whose role is to enhance wakefulness (Preston et al., 2017). An example of the drug is belsomra. Melatonin receptor agonists are drugs that play a role in activating melatonin receptor (Lichtblau, 2011). Examples include Rozerem and Hetlioz. Antidepressants cause sedation by acting upon serotonin or histamine receptors (Lichtblau, 2011). Examples include silenor, trazodone, and amitriptyline.

Potential for Addiction Associated with Sleep Disorder Medicines

Although the drugs described above play a significant role in the treatment of sleep disorders, they are associated with some form of addiction. Some people who experience sleep problems end up depending on them (Murdach, 2006; Fuermaier et al., 2014). Such people find it difficult to sleep without the drugs. As a result, they tend to abuse the drugs. It is common for such people to take large dosages for the purpose of achieving the desired effect. This is harmful to their health and general wellbeing. Some of the major symptoms of the addiction as a result of using drugs for sleep disorders include cravings for sleep pills, usage of sleep pills every time one wants to sleep, seeking prescription refills from different physicians, failed quitting attempts, continuous use despite experiencing negative effects, memory loss, and withdrawal (Murdach, 2006).

Issues Related to Malingering in the Treatment of Sleep Disorders

Malingering is a common problem when dealing with persons with sleep disorders. Since the drugs used to treat such disorders have a positive effect, some people find it necessary to feign their conditions to have more of such prescriptions (Murdach, 2006; Fuermaier et al., 2014). This constitutes malingering. For example, benzodiazepines are some of the drugs commonly prescribed for sleep disorders. Such drugs have sedative properties that make them suitable for individuals who experience sleep disturbances. Benzodiazepines are addictive. For this reason, those who use them tend to take them for a long period of time without the recommendation of healthcare experts (Fuermaier et al., 2014; Preston et al., 2017). The addiction forces these people to exaggerate their symptoms in order to get more prescriptions of benzodiazepines. It is often difficult to detect the malingering associated with sleep disorders (Fuermaier et al., 2014). This is due to the fact that the diagnosis of the conditions is based on the self-reports of the affected individuals.

Mental Health Professional’s Role in Mitigating the Potentialities of Malingering

Although it is not easy to detect malingering, mental health professionals have the responsibility in mitigating such cases. They have to pay close attention to the self-reports of patients in order to determine whether they are valid or not (Murdach, 2006). There are some important tools and approaches that can be used to differentiate between feigning and genuine symptoms. These include self-report scales, cognitive tests, and personality inventories (Fuermaier et al., 2014). Each of these methods has a specific set criterion that can be used to detect cases of malingering. For instance, the cognitive tests usually focus on the patient’s cognitive ability. While genuine patients may tend to perform poorly in most cognitive domains, the malingering ones will probably perform well in some aspects. In their efforts to curb malingering, mental healthcare professionals should be careful not to violate the confidentiality of their clients (Fuermaier et al., 2014). They have to ensure that what patients share with them does not get to other unintended parties.


Fuermaier, A. B. M., Tucha, L., Becke, M., & Tucha, O. (2014). Feigning Sleep Disorders – A Call for Research and Clinical Consideration. Journal of Sleep Medicine and Disorders, 1 (2), [1008]. Retrieved from

Lichtblau, L. (2011). Psychopharmacology Demystified. Clifton Park, NY: Delmar, Cengage Learning.

Murdach, A. D. (2006). Social Work and Malingering. Health & Social Work, 31(2), 155-8. Retrieved from

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of Clinical Psychopharmacology for Therapists (8th ed.). Oakland, CA: New Harbinger.

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