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Paradoxical insomnia

MedGen UID:
199859
•Concept ID:
C0752286
•
Mental or Behavioral Dysfunction
Synonyms: Sleep State Misperception; Sleep State Misperceptions
SNOMED CT: Paradoxical insomnia (427745001); Sleep state misperception (427745001)
 
HPO: HP:5200305

Definition

Paradoxical insomnia is a condition in which individuals with a normal or near-normal sleep macrostructure tend to severely underestimate the quantity and quality of their sleep. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVParadoxical insomnia

Professional guidelines

PubMed

Sleep disturbances, TBI and PTSD: Implications for treatment and recovery.
Gilbert KS, Kark SM, Gehrman P, Bogdanova Y
Clin Psychol Rev 2015 Aug;40:195-212. Epub 2015 Jun 3 doi: 10.1016/j.cpr.2015.05.008. PMID: 26164549Free PMC Article

Recent clinical studies

Etiology

Negative and positive sleep state misperception in patients with insomnia: factors associated with sleep perception.
Yoon G, Lee MH, Oh SM, Choi JW, Yoon SY, Lee YJ
J Clin Sleep Med 2022 Jul 1;18(7):1789-1795. doi: 10.5664/jcsm.9974. PMID: 35383568Free PMC Article
Conscious experiences and high-density EEG patterns predicting subjective sleep depth.
Stephan AM, Lecci S, Cataldi J, Siclari F
Curr Biol 2021 Dec 20;31(24):5487-5500.e3. Epub 2021 Oct 27 doi: 10.1016/j.cub.2021.10.012. PMID: 34710350
Both objective and paradoxical insomnia elicit a stress response involving mitokine production.
Martucci M, Conte M, Ostan R, Chiariello A, Miele F, Franceschi C, Salvioli S, Santoro A, Provini F
Aging (Albany NY) 2020 May 17;12(11):10497-10505. doi: 10.18632/aging.103274. PMID: 32420904Free PMC Article
Rhythms dysregulation: A new perspective for understanding PTSD?
Dayan J, Rauchs G, Guillery-Girard B
J Physiol Paris 2016 Nov;110(4 Pt B):453-460. Epub 2017 Feb 1 doi: 10.1016/j.jphysparis.2017.01.004. PMID: 28161453
Sleep education for paradoxical insomnia.
Geyer JD, Lichstein KL, Ruiter ME, Ward LC, Carney PR, Dillard SC
Behav Sleep Med 2011;9(4):266-72. doi: 10.1080/15402002.2011.607022. PMID: 22003980Free PMC Article

Diagnosis

The REM microarousal and REM duration as the potential indicator in paradoxical insomnia.
Ren W, Zhang N, Sun Y, Pan L, Hou Y, Li D, Huang X, Liu K, Sun H, Sun Y, Lv C, Yu Y, Han F
Sleep Med 2023 Sep;109:110-117. Epub 2023 Jun 30 doi: 10.1016/j.sleep.2023.06.011. PMID: 37429109
Both objective and paradoxical insomnia elicit a stress response involving mitokine production.
Martucci M, Conte M, Ostan R, Chiariello A, Miele F, Franceschi C, Salvioli S, Santoro A, Provini F
Aging (Albany NY) 2020 May 17;12(11):10497-10505. doi: 10.18632/aging.103274. PMID: 32420904Free PMC Article
The paradox of paradoxical insomnia: A theoretical review towards a unifying evidence-based definition.
Castelnovo A, Ferri R, Punjabi NM, Castronovo V, Garbazza C, Zucconi M, Ferini-Strambi L, Manconi M
Sleep Med Rev 2019 Apr;44:70-82. Epub 2018 Dec 25 doi: 10.1016/j.smrv.2018.12.007. PMID: 30731262
Paradoxical insomnia and subjective-objective sleep discrepancy: A review.
Rezaie L, Fobian AD, McCall WV, Khazaie H
Sleep Med Rev 2018 Aug;40:196-202. Epub 2018 Jan 6 doi: 10.1016/j.smrv.2018.01.002. PMID: 29402512
Insomnia and sleep misperception.
Bastien CH, Ceklic T, St-Hilaire P, Desmarais F, Pérusse AD, Lefrançois J, Pedneault-Drolet M
Pathol Biol (Paris) 2014 Oct;62(5):241-51. Epub 2014 Aug 29 doi: 10.1016/j.patbio.2014.07.003. PMID: 25179115

Therapy

A weight-independent association between atypical antipsychotic medications and obstructive sleep apnea.
Khazaie H, Sharafkhaneh A, Khazaie S, Ghadami MR
Sleep Breath 2018 Mar;22(1):109-114. Epub 2017 Jul 13 doi: 10.1007/s11325-017-1537-y. PMID: 28707161
Paradoxical insomnia in a patient taking zopiclone.
Abba-Aji A, Bardoloi P
BMJ Case Rep 2017 Jan 19;2017 doi: 10.1136/bcr-2016-217335. PMID: 28104722Free PMC Article
Treatment of paradoxical insomnia with atypical antipsychotic drugs. A comparison of olanzapine and risperidone.
Khazaie H, Rezaie L, Darvishi F, Najafi F, Avis K
Neurosciences (Riyadh) 2013 Jan;18(1):64-9. PMID: 23291800
A case of extreme paradoxical insomnia responding selectively to electroconvulsive therapy.
Case K, Hurwitz TD, Kim SW, Cramer-Bornemann M, Schenck CH
J Clin Sleep Med 2008 Feb 15;4(1):62-3. PMID: 18350965Free PMC Article

Prognosis

The REM microarousal and REM duration as the potential indicator in paradoxical insomnia.
Ren W, Zhang N, Sun Y, Pan L, Hou Y, Li D, Huang X, Liu K, Sun H, Sun Y, Lv C, Yu Y, Han F
Sleep Med 2023 Sep;109:110-117. Epub 2023 Jun 30 doi: 10.1016/j.sleep.2023.06.011. PMID: 37429109
Conscious experiences and high-density EEG patterns predicting subjective sleep depth.
Stephan AM, Lecci S, Cataldi J, Siclari F
Curr Biol 2021 Dec 20;31(24):5487-5500.e3. Epub 2021 Oct 27 doi: 10.1016/j.cub.2021.10.012. PMID: 34710350
A weight-independent association between atypical antipsychotic medications and obstructive sleep apnea.
Khazaie H, Sharafkhaneh A, Khazaie S, Ghadami MR
Sleep Breath 2018 Mar;22(1):109-114. Epub 2017 Jul 13 doi: 10.1007/s11325-017-1537-y. PMID: 28707161
Sleep education for paradoxical insomnia.
Geyer JD, Lichstein KL, Ruiter ME, Ward LC, Carney PR, Dillard SC
Behav Sleep Med 2011;9(4):266-72. doi: 10.1080/15402002.2011.607022. PMID: 22003980Free PMC Article
Quantitative electroencephalogram (EEG) in insomnia: a new window on pathophysiological mechanisms.
Marzano C, Ferrara M, Sforza E, De Gennaro L
Curr Pharm Des 2008;14(32):3446-55. doi: 10.2174/138161208786549326. PMID: 19075720

Clinical prediction guides

The REM microarousal and REM duration as the potential indicator in paradoxical insomnia.
Ren W, Zhang N, Sun Y, Pan L, Hou Y, Li D, Huang X, Liu K, Sun H, Sun Y, Lv C, Yu Y, Han F
Sleep Med 2023 Sep;109:110-117. Epub 2023 Jun 30 doi: 10.1016/j.sleep.2023.06.011. PMID: 37429109
Both objective and paradoxical insomnia elicit a stress response involving mitokine production.
Martucci M, Conte M, Ostan R, Chiariello A, Miele F, Franceschi C, Salvioli S, Santoro A, Provini F
Aging (Albany NY) 2020 May 17;12(11):10497-10505. doi: 10.18632/aging.103274. PMID: 32420904Free PMC Article
Rhythms dysregulation: A new perspective for understanding PTSD?
Dayan J, Rauchs G, Guillery-Girard B
J Physiol Paris 2016 Nov;110(4 Pt B):453-460. Epub 2017 Feb 1 doi: 10.1016/j.jphysparis.2017.01.004. PMID: 28161453
Insomnia and sleep misperception.
Bastien CH, Ceklic T, St-Hilaire P, Desmarais F, Pérusse AD, Lefrançois J, Pedneault-Drolet M
Pathol Biol (Paris) 2014 Oct;62(5):241-51. Epub 2014 Aug 29 doi: 10.1016/j.patbio.2014.07.003. PMID: 25179115
Sleep education for paradoxical insomnia.
Geyer JD, Lichstein KL, Ruiter ME, Ward LC, Carney PR, Dillard SC
Behav Sleep Med 2011;9(4):266-72. doi: 10.1080/15402002.2011.607022. PMID: 22003980Free PMC Article

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