Hysterical sleep episodes as a manifestation of masked depression

A 55-year-old man suffered from compulsive sleep episodes as a manifestation of masked depression. Although the overt symptoms were conversive in nature, the treatment which finally focused on the depression was followed by disappearance of the patient's recurring sleeping spells for the first time in 4 years. Three methods were used: a) supportive psychotherapy, b) behavior therapy, and c) antidepressive medication. We conclude that the behavior treatment indirectly revealed the masked depression previously concealed by rigid defense mechanisms.