Paradoxical Insomnia: a complaint of severe insomnia in the context of no objective evidence of sleep disturbance. Also known as Sleep State Misperception, Paradoxical insomnia involves a distortion in the perception of sleep. People who experience it get plenty of sleep but feel they do not. Because the boundaries between sleep and wakefulness are unclear, they interpret their experience as insomnia.


Paradoxical Insomnia involves a disparity between feelings of severe insomnia and the amount of sleep obtained.  There is no objective evidence to support a claim of insomnia. However, the concern is genuine, as opposed to malingering (faking) symptoms.
       People with this disorder are convinced they are awake for long periods, night after night. They feel as aware of their surroundings as they are during wakefulness. The amount of time taken to fall asleep, as well time spent awake during the night is grossly overestimated. The impact of apparent insomnia is minimal, with only moderate daytime tiredness and lack of energy.

> Paradoxical vs. Psychophysiological. Both problems involve a complaint of being awake for long periods at night, unable to quiet the mind. Both involve stress or even a fixation on not being able to fall sleep, followed by feelings the next day of not having slept. The difference is that those with Paradoxical Insomnia actually slept during the time they perceived themselves to be awake.


A sleep disorders evaluation will determine whether another type of insomnia or sleep disorder is present. Disclosing your personal or family history of sleep disorders, as well as the use of certain medications or recreational drugs, will help the sleep specialist.
    A two week sleep diary is particularly important. The log should reflect: bedtime, the time it takes to fall asleep, the number and duration of awakenings during the night, and the time you arise from sleep. Include input from bed partners. A sleep study may be performed to record brainwaves, muscular activity and breathing during the course of a night's sleep. A positive diagnosis can be made if a discrepancy is found between the polysomnogram and sleep logs before and during the test.


   Paradoxical Insomnia incorporates some of the same therapies for treating other forms of insomnia:
Good Sleep Hygiene:  undermines poor sleep habits, which aggravates stress about sleep.
Cognitive Behavioral Therapy (CBT): psychotherapies designed to improve sleep-related behavior, including:
Stimulus Control:  which trains the mind to go to bed when "feeling" sleepy, thereby creating an association between sleep and getting enough rest.
Sleep Restriction Therapy: which reduces the number of hours in bed until the perception of sleep is unmistakeable.
Medication: a temporary cycle of medication may help improve the process of sleep and therefore the perception of it. Commonly used prescription medications include: Zolpidem (Ambien), Eszopiclone  (Lunesta), and Trazadone (Desyrel).

Paradoxical Insomnia Mechanics

        Sleep also involves a change in the way the brain interprets information from the senses. Although deeper sleep equals less information gathered by the senses, there is always some communication with the environment. Dreaming then further impacts the process of sleep. The changes that accompany each transition can impact our interpretation of the experience. People with Paradoxical Insomnia misinterpret the boundaries between sleep and wakefulness.

Suggested Downlaods

SleepIssues:Can’t Sleep
SleepCaptions:Paradoxical Insomnia