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The Sleep Expectation-Reality Gap: Exploring Discrepancies Between Perceived and Ideal Sleep Duration in Primary Care
Carlos De Las Cuevas1,2, María Segovia3
1Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain.
Objective:
This study aimed to quantify the discrepancy between perceived and ideal sleep duration among primary care patients and identify demographic, lifestyle, and psychological factors associated with this expectation-reality gap.
Methods:
A cross-sectional study was conducted with 300 adult primary care patients, who completed a survey assessing demographics, sleep perceptions, and insomnia severity (Insomnia Severity Index, ISI). Sleep discrepancy was defined as the difference between perceived and ideal sleep duration. Statistical analyses included Wilcoxon signed-rank tests, Spearman's correlations, and multiple linear regression to examine predictors of sleep discrepancy.
Results:
Participants reported a mean perceived sleep duration of 6.39 ± 1.36 h, significantly lower than their ideal sleep duration of 8.07 ± 0.75 h (p < 0.001). A significant sleep discrepancy was found in 81.3% of participants, while only 2.0% exceeded their perceived sleep needs. Higher ISI scores were strongly associated with greater sleep discrepancy (r = -0.476, p < 0.001). The regression model explained 27.7% of the variance (p < 0.001), with insomnia severity (β = -0.425, p < 0.001), higher BMI (β = -0.192, p < 0.001), cola drink consumption (β = 0.142, p = 0.009), and older age (β = 0.163, p = 0.002) as significant predictors. Gender, hypnotic medication use, and alcohol intake were non-significant.
Conclusions:
A substantial expectation-reality gap in sleep duration exists, linked to insomnia severity, older age, and lifestyle factors. Addressing maladaptive sleep expectations through cognitive-behavioral interventions in primary care may improve sleep satisfaction and reduce insomnia-related distress.
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