KMID : 1101120230200010047
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Journal of Sleep Medicine 2023 Volume.20 No. 1 p.47 ~ p.53
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Proportion and Associated Clinical Factors of Paradoxical Insomnia in Patients With Chronic Insomnia: A Retrospective and Observational Study
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No Jin-Woo
Kim Ji-Young Lee Gha-Hyun Cho Jae-Wook Kim Hyun-Woo
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Abstract
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Objectives: Paradoxical insomnia, a type of sleep disorder, is characterized by misperception and underestimation of an individual¡¯s sleep time. In this study, we investigated the percentage and clinical factors associated with paradoxical insomnia in patients with chronic insomnia, who underwent polysomnography.
Methods: The study included 148 patients with chronic insomnia. The study population was categorized into paradoxical and non-paradoxical insomnia groups. The following criteria were used to define paradoxical insomnia: 1) total sleep time >390 min and sleep efficiency ¡Ã85.0%, and 2) significant discrepancy of >1 hour between subjective and objective sleep measurements. We analyzed demographic data, polysomnographic parameters, and perceived sleep time in all patients.
Results: Among 148 patients with chronic insomnia, 33 (22.6%) had paradoxical insomnia. We observed significant intergroup differences in age, sex, and the Insomnia Severity Index (ISI). Sleep architecture patterns were relatively better in the paradoxical than in the non-paradoxical insomnia group. Logistic regression analysis was performed to determine clinical factors associated with paradoxical insomnia. Female sex (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.19?7.37), age (OR 0.97, 95% CI 0.94?0.99), and ISI (OR 1.18, 95% CI 1.05?1.31) were significantly associated with paradoxical insomnia.
Conclusions: Approximately 20.0% of patients with chronic insomnia were classified into the paradoxical insomnia group, and female sex, age, and ISI were identified as clinical factors associated with this type of sleep disorder.
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KEYWORD
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Sleep state misperception, Insomnia, Polysomnography
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