Paradoxical insomnia is a complaint of insomnia that occurs without objective signs of sleep disturbance. Paradoxical insomnia is also called pseudo-insomnia, insomnia without objective findings (subjective insomnia), sleep hypochondriasis and subjective sleep complaint (misperception of sleep). The incidence is higher in women.
In paradoxical insomnia, there is actually no real insomnia. However, the need for sleep and the expectation of sleep are incompatible. Patients state that they sleep very little or not at all, such as 3-4 hours. However, it is seen that they are asleep in observations and tests. There is no obvious psychopathology in the patients, but the patient actually complains that he is sleep deprived even if his sleep is sufficient.
How is paradoxical insomnia diagnosed?
To be able to diagnose paradoxical (subjective) insomnia, it must have one of the following characteristics:
- Insomnia must be for at least 1 month
- The patient should describe mostly sleepless or very little sleepy nights as well as normal sleepy nights from time to time.
- Numerous sleepless or completely sleepless nights followed by no daytime sleep when sleep diary is kept.
- Patient-reported complaints or inconsistency between sleep diary and polysomnography or actigraph
How is paroxysmal insomnia treated?
Paroxysmal insomnia should be treated in a well-equipped sleep center or clinic with detailed evaluation. It is evaluated together with the treatment of other conditions specific to the patient.