Finally, Accurate Perceptions about Sleep-State Misperceptions
Although simply a Letter to the Editor in the journal SLEEP, these authors put forward an excellent argument to explain sleep state misperceptions as a physiologically driven problem, not something simply misperceived in the insomniac’s mind. This is a great step forward and aligns with the concepts our research team and my books have pointed out for more than two decades. Namely, when someone experiences lighter sleep in conjunction with a tendency toward anxiety during waking hours, the natural capacity to distinguish between being awake and being sleep can be compromised.
Such individuals often are tested in sleep labs after which sleep doctors “explain” to them that the data show more hours of sleep than the individuals think, report or know they are receiving. You can imagine how confusing such a discussion would be for the individual, who initially might believe the doctor is making up stuff about their sleep. In many of these awkward conversations, patients are put on the defensive as if they are lying about their sleep. In some cases, the patients become embarrassed or ashamed and don’t know how to react.
We saw this problem in the mid-1990s and knew a physiological component must be a better explanation. Though technically, psychophysiology is a better term. We worked with PTSD patients suffering from hypervigilance, which appeared to carry over into their sleeping periods. Unless these patients were sleeping deeply, they could just as easily tell us their experience was either “light sleep” or “being awake.” And, they would admit that sometimes they could not distinguish between the two.
The pivotal factor we observed to explain the phenomenon were the subtle breathing events of UARS causing brief episodes of EEG arousal and overall sleep fragmentation. Thus, the afflicted person had a very good reason for believing he or she was not asleep, because by brain wave measurement they were in fact awake if only for a few seconds at a time.
Sadly, the field of sleep medicine has embarrassed itself by continuing to talk about sleep state misperception in these derogatory terms. But, this new approach from this group of Australian sleep researchers should help change direction of the conversation
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