Patients’ misperceptions about the actual time they sleep is a well-known phenomenon in sleep research. Patients’ own impressions of their sleep behavior is often quite different from that demonstrated by clinical measurements. A research group led by Karin Trimmel and Stefan Seidel from MedUni Vienna’s Department of Neurology (Outpatient Clinic for Sleep Disorders and Sleep-Related Disorders) compared patients’ actual total sleep time and their self-reported sleep time and also analyzed the associated factors. The study is published in the Journal of Clinical Sleep Medicine.

The group retrospectively analyzed patient consultations from between 2012 and 2016 and polysomnograms (PSG) of a representative group of 303 sleep clinic patients, 49% of whom were women. 32% had insomnia, 27% sleep-related breathing disorders, 15% sleep-related movement disorders, 14% hypersomnia/narcolepsy, and 12% parasomnias.

There was a discrepancy between self-reported perception and objective readings in all sleep disorders, although it was largest in the case of insomnia, irrespective of age, sex, or whether the monitored night was spent in the sleep lab or at home.

Insomnia patients overestimate their sleep latency and significantly underestimate the amount of total sleep time. A constantly elevated level of background stress (hyperarousal) could be a factor in this, since this would result in disrupted sleep architecture (increased number of microarousals), as well as the fact that insomnia is often associated with psychiatric comorbidities.

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In contrast to insomnia patients, patients with other sleep disorders tended to underestimate their sleep latency and overestimate their total sleep time.

The study corroborates the clinical observation that sleep misperception occurs in all forms of sleep disorder but is most prevalent in insomnia. Trimmel says in a release, “By incorporating this misperception into behaviural therapy, we can significantly improve treatment outcomes, so that polysomnography is highly recommended for patients with treatment-resistant insomnia.”

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