Other terms used in the past to describe patients with this disorder include subjective insomnia, pseudo-insomnia, subjective sleepiness, and sleep hypochondriasis. The RDC criteria also provided three subclassifications of primary insomnia: psychophysiologic insomnia, paradoxical insomnia, and idiopathic insomnia. The American Academy of Sleep Medicine developed Research and Diagnostic Criteria (RDC) for insomnia ( 03). In the ICSD-3 edition, the term sleep state misperception was replaced with “paradoxical insomnia” and will be used where appropriate herein ( 02). Sleep state misperception (paradoxical insomnia) is a diagnostic term adopted in the International Classification of Sleep Disorders ( 04) to replace two previously used diagnostic categories of sleep disorders: subjective insomnia complaint without objective findings and subjective sleepiness complaint without objective findings. Polysomnographic recordings do not show evidence of sleep disorder, and sleep parameters such as sleep efficiency and sleep onset latency are within normal limits.Patients do not show other evidence of malingering or psychopathology.Subjective overestimation of sleep onset latency is more common than underestimation in insomnia patients.Patients show evidence of overestimation of sleep onset latency and underestimation of sleep efficiency.Paradoxical insomnia should be considered in patients with insomnia who complain of severe insomnia, with little or no sleep but without objective evidence of consequences commensurate with the described level of sleep deprivation.Behavioral therapy and sedative hypnotics have also been tried. Treatment of paradoxical insomnia usually involves patient reassurance. Emerging literature has suggested that underestimation of one’s total sleep time has been linked to cases of subjective total insomnia, and sleep wake misperception is relatively common across various sleep wake diagnoses. Sleep study reveals normal sleep architecture with normal sleep onset latency and sleep efficiency, but with subjective patient reports indicating prolonged sleep onset latency and poor sleep efficiency. Patients often describe heightened awareness of their surroundings when lying down to sleep. Paradoxical insomnia (previously called sleep state misperception) is characterized by complaints of little or no sleep over long periods of time without the level of impairment expected with such a level of sleep deprivation.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |