Is Factitious Disorder Imposed on Another (FDIA) a Sleep Disorder?

I remember the first time I stumbled upon the chilling case of Dee Dee and Gypsy Rose Blanchard. Their story, which inspired the American biographical crime drama The Act, left me shaken.

The layers of deception, psychological manipulation, and fabricated illnesses made me wonder—how deep does Factitious Disorder Imposed on Another (FDIA) go?

More importantly, could it be linked to real case studies and sleep disorders in ways we have yet to fully understand?

Darker Side of Sleep

FDIA—previously known as Munchausen syndrome by proxy—is a psychiatric disorder where a caregiver fabricates or induces illness in another person, often a child, for attention or personal gain.

While its psychological implications are well-documented, I’m about to explore an aspect that’s hardly talked about: What happens when sleep itself becomes the victim?

Manipulation & Disturbed Reality in ‘The Act’

When I first watched The Act, the American biographical crime drama about Gypsy Rose Blanchard and her mother, Dee Dee, I was horrified. Dee Dee convinced the world that her daughter had multiple illnesses—forcing her into a wheelchair, feeding her unnecessary medications, and even making her undergo medical procedures she didn’t need.

One detail stood out to me: Gypsy was often drugged, making her drowsy and confused. Her sleep cycles were entirely dictated by her mother, who controlled when and how she rested.

This got me thinking—could sleep manipulation be an overlooked sign of factitious disorder imposed on another?

According to the DSM-5 (American Psychiatric Association), FDIA is characterized by persistent deception regarding a victim’s health, including inducing symptoms that require medical intervention. In many reported cases, sleep deprivation or medically-induced drowsiness is a common element.

Is FDIA Related to Sleep Disorders?

• According to a study published in PubMed (Factitious Cyclic Hypersomnia: A New Variant of Factitious Disorder), some individuals with factitious disorder deliberately simulate recurrent episodes of excessive sleep.

In FDIA cases, caregivers may exaggerate or fabricate a dependent’s sleep disorder, leading to unnecessary medical treatments, medication misuse, and prolonged sleep disturbances.

These fabricated conditions can create long-term sleep dysfunction, even after the victim is removed from the abusive environment.

• Further, research in Sleep Disorders Medicine (Oxford Academic) highlights how Münchausen Syndrome by Proxy and Sleep Disorders are interlinked. Some caregivers intentionally manipulate a child’s sleep, either by inducing insomnia through stimulant use or enforcing hypersomnia through sedatives.

This chronic disruption can lead to circadian rhythm disorders, dependence on sleep aids, and psychological distress related to bedtime.

Addressing FDIA requires a multidisciplinary approach – involving psychiatric intervention, sleep therapy, and in severe cases, sleep rehabilitation programs to reset sleep cycles and health of the victims.

My Perspective | Sleep Crisis

Factitious Disorder Imposed on Another (FDIA) is a disturbing and insidious form of abuse—but what often goes unnoticed is its impact on sleep health. While medical harm and psychological trauma are widely discussed, the long term effects on sleep remain an overlooked consequence.

As someone who has explored the deep ties between mental health and sleep, I find it alarming that FDIA victims often suffer chronic sleep disturbances without proper diagnosis or intervention.

Many FDIA victims, especially children, are forced into unnecessary medical treatments, hospital stays, and sedative use—all of which disrupt natural sleep patterns.

Hidden Impact | Factitious Disorder Imposed on Another

Sleep is fundamental to both physical healing and emotional well-being, and when disrupted, it can lead to lifelong sleep disorders, PTSD-related insomnia, and even chronic fatigue syndromes. What’s worse, the trauma of being manipulated by a trusted caregiver fosters a constant state of hypervigilance.

FDAI can contribute to serious sleep disorders, many of which persist even after the victim is removed from the abusive environment.

Sleep Disorders

Here I’ve listed out some of the most common sleep disturbances FDIA victims experience.

1. Insomnia

• Forced medical procedures create pain, anxiety, and long-term sleep disturbances.
• Psychological trauma from betrayal leads to wakefulness, preventing deep sleep.
• Constant fear and stress result in trouble falling or staying asleep.

2. Nightmares & Sleep Anxiety (Parasomnia Disorders)

• The trauma of medical abuse leads to recurring nightmares.
• Victims associate sleep with danger, fearing what might happen while they are unconscious.

3. Sleep-Wake Cycle Disruptions (Circadian Rhythm Disorders)

• Hospital stays and medical interventions disrupt the body’s natural sleep cycle.
• Frequent sedation or forced wakefulness interferes with melatonin production.
• Victims struggle to maintain a normal bedtime routine, even after recovery.

4. Hypersomnia (Excessive Daytime Sleepiness)

• Many victims are subjected to unnecessary sedatives, creating dependence on medications that induce sleep.
• Once removed from the abusive environment, the body struggles to regulate wakefulness.

5. PTSD Related Sleep Disorders

• Many FDIA victims develop Post Traumatic Stress Disorder (PTSD), which is known to cause severe sleep disturbances.
• Flashbacks, anxiety, and wakefulness prevent deep, restorative sleep.

I’ve provided a clear representation of the cycle that plays between sleeplessness and Factitious Disorder Imposed on Another in tabular form.

Table:  Vicious Cycle – Factitious Disorder and Sleeplessness

Real-Life Horror Story – Mothers Deadly Deception

1. Case Study 1

In a chilling factitious disorder imposed on another example from CBS News (January, 2025) stated that in North Texas, a 56-year-old woman named Lisa Campbell-Goins was arrested. She was charged with exploitation of a child, injury, and unlawful restraint.

Authorities allege that Campbell-Goins had an unnecessary gastric feeding tube placed into her granddaughter and solicited monetary donations for her care, including through a GoFundMe account. The Tarrant County Sheriff’s Office is seeking individuals who made financial donations to Campbell-Goins, as part of their investigation into this case of medical child abuse.

2. Case Study 2

Similarly, in another news report a mother, Denise A. Zamora, from Tarrant County (December, 2024, North Texas) was arrested for allegedly submitting false medical histories of her 15-year-old daughter. This led to unnecessary and potentially harmful medical procedures over a six-year period. Authorities reported that she is held accountable for administering unnecessary medications like an anesthetic Ketamine, to make her victim dependent on her.

Cases like this highlight the factitious disorder imposed on another signs—a caregiver who appears too eager for medical intervention, unexplained symptoms that worsen at home but improve in medical settings, and an unusual dependence on medications.

How to Deal with a Family Member with Factitious Disorder?

If you suspect a loved one is suffering due to Factitious Disorder Imposed on Another (FDIA), taking action is crucial. The condition is complex, requiring both medical and psychological intervention.

Here’s how you can address the situation,

1. Recognize the Signs and Symptoms

• Look for factitious disorder imposed on another signs, such as unnecessary medical procedures, inconsistent medical histories, or the caregiver seeking constant medical attention for the victim.
• The perpetrator may appear overly involved in the victim’s health, refusing second opinions or changing doctors frequently.
• Victims often experience unexplained sleep disturbances due to medication misuse or imposed irregular sleep cycles.

2. Gather Evidence and Seek Professional Guidance

• Document suspicious medical treatments and track changes in the victim’s health.
• Consult a medical professional or psychologist to assess the situation.
• In some cases, medical record reviews may reveal unnecessary hospitalizations or conflicting diagnoses, confirming factitious disorder imposed on another symptoms.

3. Ensure Immediate Protection for the Victim

• If the victim is a child or a dependent adult, contact child protective services or law enforcement to ensure their safety.
• Victims may require hospitalization not for their ‘illness’ but to protect them from further harm.
• Removing them from the caregiver’s influence is necessary to prevent further medical exploitation.

4. Seek Psychiatric Treatment for the Perpetrator

• Factitious disorder imposed on another treatment primarily focuses on psychiatric therapy for the caregiver.
• Therapy aims to address underlying psychological issues, often rooted in trauma, personality disorders, or a need for attention.
• If the perpetrator refuses treatment, legal intervention may be necessary.

5. Support the Victim’s Trauma Recovery

• Victims often suffer from post-traumatic stress disorder (PTSD), anxiety, and sleep disorders due to prolonged manipulation.
• Therapy should focus on rebuilding trust, restoring autonomy, and healing psychological wounds.
• Re-establishing normal sleep patterns is essential, especially if the victim was subjected to sleep deprivation or unnecessary sedatives.

6. Educate Family Members and Caregivers

• Awareness is key to preventing future cases of FDIA.
• Educate close relatives about the factitious disorder imposed on another definition and how to identify early warning signs.
• Encourage open discussions about medical history, second opinions, and mental health support.

7. Follow Disease Prevention Guidelines

• Medical professionals and caregivers must adopt FDIA prevention strategies such as thorough case reviews and limiting unnecessary treatments.
• Hospitals and clinics should implement guidelines for monitoring caregivers who frequently seek medical intervention for dependents.
• Strengthening mental health resources for caregivers may help reduce FDIA cases.

Factitious Disorder Imposed on Another | Symptoms

As discussed in the earlier sections, FDIA—or Munchausen Syndrome by Proxy—is a severe psychiatric disorder in which a caregiver fabricates, exaggerates, or induces illness b (typically a child, elderly adult, or dependent individual).

Why so? The goal is to gain attention, sympathy, or a sense of control.

Key Symptoms of FDIA

1. Unexplained or Persistent Medical Issues in the Victim

• • The victim undergoes frequent hospitalizations with no clear diagnosis.
  • Symptoms improve when separated from the caregiver but return when reunited.

2. Conflicting Medical History (Inconsistency Noted)

• • The caregiver provides detailed yet inconsistent medical accounts.
  • Multiple doctors and hospitals are involved, often with no clear resolution.

3. Suspicious Behavior on part of the Caregiver

• • Overly eager for medical procedures, pushing for unnecessary treatments.
  • Reluctant to leave the victim alone with medical professionals.
  • Becomes defensive or aggressive when questioned about symptoms.

4. Induced Sleep Disturbances

• • Victims may be subjected to excessive sedatives, leading to daytime drowsiness.
  • Forced hospital stays disrupt normal sleep patterns.
  • Sleep anxiety and nightmares arise due to ongoing trauma.

5. Caregiver’s Emotional Reward from Medical Attention

• • Appears calm or even pleased despite the victim’s suffering.
  • Actively seeks support groups, social media attention, or donations.

Early detection is crucial, as FDIA can lead to serious medical harm, long-term trauma, and even death if left unaddressed.

Treatment Interventions

Treating FDIA is complex, as it involves both the perpetrator and the victim. A multi-disciplinary approach is required, combining psychiatric intervention, legal action, and trauma recovery for the victim.

1. Protecting the Victim

• Immediate separation from the caregiver may be necessary to prevent further harm.
• Medical professionals and social services assess the victim’s physical and psychological condition.
• Re-establishing normal sleep patterns is critical if the victim has suffered medication misuse or sleep deprivation.

2. Cognitive Therapy and Rehabilitation – Malefactor

• FDIA stems from deep-seated psychological issues, often involving trauma, personality disorders, or a compulsive need for validation.
• Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are commonly used to address impulse control and emotional regulation.
• If the caregiver denies wrongdoing, court-ordered psychiatric evaluation and treatment may be required.

3. Recovery and Sleep – Victim

• Victims often develop Post Traumatic Stress Disorder (PTSD), depression, anxiety, and trust issues.
• Therapy and counseling help rebuild self-confidence and a sense of independence.
• Addressing sleep disorders is a crucial step in restoring the victim’s physical and mental health.

4. Legal and Social Intervention

• FDIA is a form of child abuse and, in some cases, a criminal offense.
• Law enforcement, child protective services, and medical professionals work together to prevent further harm.
• Educating families, doctors, and caregivers on factitious disorder imposed on another signs can help prevent future cases.

Factitious Disorder vs. Malingering

A common misconception is that factitious disorder vs. malingering are the same. They’re not.

I’ve enlisted the key differences in the table below.

The Overlooked Impact on Sleep Health

When it comes to factitious disorder imposed on another symptoms, sleep disturbances often go unnoticed. Victims may experience,

• Excessive daytime sleepiness due to sedatives or medications
• Chronic insomnia from forced medical interventions and hospital stays
• Nightmares or sleep anxiety caused by ongoing trauma and manipulation
• Unexplained lethargy despite no underlying condition, often due to caregiver-induced dependency on medications

Can Medically Recommended Mattresses Help?

Victims of FDIA often suffer long-term sleep disorders due to years of manipulated rest cycles. Chiropractor approved mattresses play a key role in sleep rehabilitation. Specialized mattresses for sleep disorders can help regulate disrupted sleep patterns.

From pressure-relief foam to adjustable firmness, these mattresses cater to individuals recovering from factitious disorder imposed on other prognosis issues related to – sleep deprivation, PTSD, and chronic fatigue.

Smart Take!

Sleep is one of the most vital yet fragile aspects of health.

FDIA shatters a victim’s ability to experience restful, restorative sleep. Even after escaping the abuse, many victims continue to suffer from sleep disorders for years.

This is why treatment should not only focus on psychological healing but also sleep rehabilitation—including Cognitive Behavioral Therapy for insomnia (CBT-I), trauma-informed sleep strategies, and lifestyle interventions.

Raising awareness about FDIA’s hidden impact on sleep is crucial in ensuring victims get the help they need—not just to survive, but to truly heal.

Disclaimer

The information provided in this article is for educational and awareness purposes only and should not be used as a substitute for professional medical, psychological, or legal advice.

Factitious Disorder Imposed on Another (FDIA) is not just a psychiatric condition—it is a form of abuse that can have lifelong physical and psychological consequences for the victim. Addressing it requires vigilance, professional intervention, and long-term support for survivors.

If you suspect FDIA in a loved one’s life, taking early action can be life-saving. If you or someone you know may be affected, seek immediate assistance from qualified healthcare professionals, mental health specialists, or legal authorities.