Journal of sleep researchNov 15, 2023

Sleepiness and related sleep problems in functional movement disorders compared to central excessive sleepiness

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Updated Mar 27, 2026

Abstract

Among 37 patients with functional motor disorders, 62% reported excessive daytime sleepiness.

Specific sleep disorders were identified in the cohort, with 35% having restless legs syndrome, 49% obstructive sleep apnea, and 8% periodic limb movements in sleep.
There was no correlation between subjective sleepiness and the presence of these sleep disorders.
Patients with functional motor disorders who reported sleepiness exhibited higher levels of fatigue and depression compared to those with central hypersomnia.
Longer sleep latencies were observed in the multiple sleep latency test for patients with functional motor disorders who reported sleepiness.
A positive correlation was found between self-reported sleepiness and fatigue in patients with functional motor disorders.

Simplified

Sleep symptoms, including excessive sleepiness, are frequently reported by patients with functional motor disorders (FMD). We aimed to classify the comorbid sleep disorders in FMD, and to investigate the relationship between subjective sleepiness and objective measures of hypersomnia, comparing them with data from people with central hypersomnia. A total of 37 patients (mean [SD] age 46.4 [11.2] years) with clinically definite FMD, and 17 patients (mean [SD] age 41.1 [11.6] years) with central hypersomnia underwent structured medical and sleep history, neurological examination, polysomnography, multiple sleep latency test (MSLT), and questionnaires assessing sleepiness, fatigue, and depression. In all, 23 patients with FMD (62%) reported excessive daytime sleepiness. Evidence of specific sleep disorders was identified in our cohort, with 35% having restless legs syndrome; 49% obstructive sleep apnea; and 8% periodic limb movements in sleep; however, the presence of these disorders was not correlated with subjective sleepiness. Patients with FMD with self-reported sleepiness reported higher fatigue (p = 0.002), depression (p = 0.002), and had longer sleep latencies in the MSLT (p < 0.001) compared to the patients with central hypersomnia. No correlation was found between subjective and objective sleepiness in either group. Fatigue positively correlated with self-reported sleepiness in patients with FMD (p < 0.001). This study did not find objective correlates of increased sleepiness in patients with FMD. While sleep abnormalities were found to be common in FMD, they were not correlated with self-reports of excessive sleepiness. Positive correlations between self-reported sleepiness and fatigue support the current unified model of non-motor symptoms in FMD.

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Sleepiness and related sleep problems in functional movement disorders compared to central excessive sleepiness

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