THE DISTRIBUTION AND CLINICAL-SIGNIFICANCE OF SLEEP TIME MISPERCEPTIONS AMONG INSOMNIACS

It is well recognized that sleep time misperceptions are common among insomniacs, but little is known about the distribution and clinical si gnificance of these subjective distortions. The current investigation was conducted to examine the distribution of sleep time misperceptions among a large (n = 173), diverse group of insomniacs and to determine if such misperceptions might relate to the patients' clinical charact eristics. Consistent with previous studies, our subjects, as a group, produced sleep estimates that were significantly (p < 0.0001) lower th an polysomnographically determined sleep times. However, patients' sle ep time perceptions were widely distributed across a broad continuum, which ranged between gross underestimates and remarkable overestimates of actual sleep times. Results also showed that subgroups, formed on the basis of presenting complaints and diagnostic criteria (i.e. Inter national Classification of Sleep Disorders nosology), differed in rega rd to the magnitude and direction of their sleep distortions. Moreover , these differences appeared consistent with the types of objective sl eep disturbances these subgroups commonly experience. Hence, the tende ncy to underestimate actual sleep time is not a generic attribute of a ll insomniacs. Furthermore, it appears that the accuracy and nature of sleep time perceptions may relate to the type of sleep pathology unde rlying insomniacs' presenting complaints.