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Reconsidering sleep perception in insomnia: from misperception to mismeasurement
Aurélie M Stephan1,2,3, Francesca Siclari1,2,3
1The Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.
Journal of Sleep Research
|September 7, 2023
Summary
Sleep misperception is often accurate, but some insomniacs underestimate sleep duration due to increased cortical activation during sleep. This feeling of wakefulness during sleep is linked to brain activity changes.
Area of Science:
- Neuroscience
- Sleep Medicine
Background:
- Sleep misperception describes feeling awake despite objective sleep measures.
- The cause is debated: abnormal perception vs. limitations of standard sleep recordings.
Approach:
- Systematic review of studies on sleep macro/microstructure, metabolism, and mental correlates.
- Analysis of polysomnography (PSG) and advanced electroencephalography (EEG) techniques.
Key Points:
- Most individuals accurately estimate sleep duration via PSG.
- Good sleepers feel awake at sleep onset and early stages, but not REM sleep.
- Insomnia patients consistently underestimate sleep, feeling awake even during REM sleep.
Conclusions:
- Insomnia is associated with "wake-like" brain activity, indicated by metabolic and microstructural EEG changes.
- These changes suggest increased cortical activation during sleep in insomniacs.
- Further research is needed to understand and address sleep misperception.
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