# AI recommends sleep restriction therapy for insomnia without screening for bipolar disorder or seizure disorders

- **ID:** `mental-health/sleep-restriction-for-insomnia`
- **Domain:** mental-health
- **Category:** data_error
- **Error Code:** `INSOMNIA-SLEEP-RESTRICT-001`
- **Verification:** ai_generated
- **Fix Rate:** 80%

## Root Cause

Sleep restriction therapy, a standard CBT-I technique, can trigger manic episodes in undiagnosed bipolar disorder or increase seizure risk in epilepsy; AI fails to assess contraindications before recommending.

## Workarounds

1. **Always include a pre-screening question: 'Before trying sleep restriction therapy, have you ever been diagnosed with bipolar disorder, seizure disorder, or experienced manic episodes?' If yes, redirect to a clinician.** (90% success)
   ```
   Always include a pre-screening question: 'Before trying sleep restriction therapy, have you ever been diagnosed with bipolar disorder, seizure disorder, or experienced manic episodes?' If yes, redirect to a clinician.
   ```
2. **Provide a minimum sleep duration guideline (e.g., never restrict below 5.5 hours per night) and a maximum consecutive use warning (e.g., no more than 2 weeks without professional oversight).** (75% success)
   ```
   Provide a minimum sleep duration guideline (e.g., never restrict below 5.5 hours per night) and a maximum consecutive use warning (e.g., no more than 2 weeks without professional oversight).
   ```
3. **Offer alternative first-line insomnia treatments such as stimulus control, sleep hygiene education, or relaxation techniques before sleep restriction.** (85% success)
   ```
   Offer alternative first-line insomnia treatments such as stimulus control, sleep hygiene education, or relaxation techniques before sleep restriction.
   ```

## Dead Ends

- **** — Does not proactively screen for contraindications; user may not recognize they have bipolar disorder or epilepsy (65% fail)
- **** — Missing concrete parameters (e.g., minimum 5 hours in bed) leads to dangerous under-sleeping (70% fail)
- **** — Ignores comorbid conditions like restless legs syndrome or sleep apnea that require different treatment (55% fail)