Sleep disorders in meningoencephalitis with adjustment disorders

Many patients with medical disorders, such as meningoencephalitis are evaluated by psychiatrists complaining of sleep problems as one of the symptoms. A 65-years old married male patient who was currently unemployed was interviewed by a psychiatrist in an uncomfortable reclining position. The patient had been hospitalized for 8 days prior to the interview with a history of being unconscious. The patient showed disorganized speech, tried to pull the intravenous line, and hit his wife. The patient said that at this time, he was unable to sleep due to the throbbing headaches, nauseous, and frequent urination at night. Thus, the patient felt uncomfortable, tired, and drowsy in the morning. Those symptoms got worse in the last week.  The patient never had sleep problems before. The psychiatric status showed an appropriate appearance, uncomfortable looks, adequate verbal and visual contact, clear consciousness, dysphoric mood and affect which was congruent, logical realist coherent thought process, and a preoccupation of headache. There was no hallucination or illusion, but mixed type insomnia was found. The patient was diagnosed with adjustment disorder with predominant symptoms and sleep disturbances (F43.28).