In this video, Mitchell Miglis, MD, Stanford University, Palo Alto, CA, discusses autonomic dysfunction in primary sleep disorders, drawing focus on the strong bi-directional relationship between the two. Dr Miglis first discusses autonomic symptoms in REM sleep behavior disorder (RBD) and hypersomnia, explaining that these are not fully understood due to the complex pathways involved. Dr Miglis then details some recent research investigating dysautonomia in idiopathic hypersomnia and concludes by discussing how autonomic symptoms interact with sleepiness and fatigue and influence disease outcomes. This interview took place during the World Sleep Congress 2022 in Rome, Italy.