Misperception of Sleep Quality Is Common in Patients With Insomnia

Compared to those with other sleep disorders, patients with insomnia often misperceive their sleep duration and sleep efficiency of each night.

People with insomnia frequently misperceive how much and how well they sleep each night, according to a study in the Journal of Clinical Sleep Medicine.

Data is lacking on predicting factors for sleep, and previous studies have indicated a discrepancy between self-reported and objective sleep parameters. To assess self-reported sleep perception in patients with sleep disorders, researchers in this study retrospectively evaluated 303 polysomnography (PSG) tests conducted between 2012 and 2016 at a single sleep lab. Each patient underwent a comprehensive semi-structured interview on their general and sleep history prior to PSG testing. The investigators applied linear regression to predict discrepancies between self-reported and objective sleep parameters, including total sleep time (TST), sleep efficiency (SE), and sleep latency (SL).

Participants in this study (median age, 48 years) had insomnia (32%), sleep-related breathing disorders (27%), sleep-related movement disorders (15%), hypersomnia/narcolepsy (14%), and parasomnias (12%). The best predictor of discrepancy between self-reported and objective TST in this population was insomnia compared with sleep-related breathing disorder (P <.001), parasomnia (P <.001), hypersomnia/narcolepsy (both P =.001), and sleep-related movement disorders (P =.008). There was a significant effect for lower arousal index (P =.007).

Participants with insomnia significantly underestimated TST (median discrepancy, 46 minutes; P <.001) and SE (median discrepancy, 11%; P <.001). Other patient groups did not demonstrate significant differences between self-reported and objective SE. Patients with sleep-related breathing disorders overestimated their TST by a median of 11 minutes (P =.003).

Limitations of this study included its single-center design, retrospective nature, and lack of control data which may have limited the generalizability of results.

The study researchers concluded that these findings indicate the “assessment of differences of self-reported vs objective sleep measures may form an integral part of the behavioral treatment of insomnia” and “supports the extended use of PSG in these patients.”


Trimmel K, Eder HG, Böck M, Stefanic-Kejik A, Klösch G, Seidel S. The (mis)perception of sleep: factors influencing the discrepancy between self-reported and objective sleep parameters. J Clin Sleep Med. Published online January 4, 2021. doi:10.5664/jcsm.9086