Have you ever felt like you were awake for the whole night despite having actually slept? Does your partner say you sleep soundly but you still wake up tired as you didn’t get enough sleep? If so, you may suffer from paradoxical insomnia, also known as subjective insomnia or sleep state misperception. Now, in case you aren’t familiar with it, let’s have a closer look at paradoxical insomnia.

Paradoxical Insomnia Basics

Considered a subtype of chronic insomnia, paradoxical insomnia is characterized by feeling as if you haven’t slept for the entire night or didn’t get the sleep needed. This condition can be quite challenging and frustrating since it can last for months, even years.

Paradoxical Insomnia Symptoms

Fortunately, you don’t experience true sleep deficit with paradoxical insomnia, which is the case with chronic insomnia. However, you would still have certain symptoms which are typically the same as for insomnia, including:

• Feeling like you’ve been awake most of the night
• Constant worrying while trying to fall asleep
• Not being able to function at work or socially
• Feeling unrefreshed in the morning
• Extreme sleepiness during the day

Paradoxical Insomnia Causes

In general, paradoxical insomnia is a disorder that hasn’t been studied enough yet so the exact cause of it isn’t currently known. Certain studies have linked paradoxical insomnia with some psychiatric conditions and found changes in brain function which may help clarify the causes of the disorder.

Precisely speaking, one study noted changes in key areas of the brain responsible for the perception of sleep and the regulation of our sleep-wake cycles. Another study found that paradoxical insomnia is more common in those who suffer from depression or anxiety. Furthermore, a different study showed that this sleep disorder typically goes hand in hand with some psychiatric conditions like bipolar disorder, schizophrenia, and alcohol dependency.

Paradoxical Insomnia Treatment

At the moment, as paradoxical insomnia is a largely understudied disorder, general treatment guidelines don’t exist. Still, research shows that a combination of some strategies may be effective in treating the disorder. These treatment options include:

• Sleep education
• Psychotherapy
• Medication

When it comes to sleep education, anyone having sleep issues should focus on getting educated about sleep and learning what’s important for getting quality sleep. One aspect to focus on is sleep hygiene which means that you should follow a strict sleep schedule, make your bedroom sleep-friendly, limit screen time, mind your diet, etc.

Psychotherapy is yet another treatment option you may consider. The best type of psychotherapy for treating paradoxical insomnia is thought to be cognitive behavioral therapy (CBT). Even though there isn’t enough research to prove the effectiveness of this type of therapy, it is more than reasonable to recommend it as CBT helps in restoring healthier beliefs and perspectives.

Last but not least, sedative and hypnotic agents are medications that are usually used for treating chronic insomnia and could also be helpful for paradoxical insomnia. These medications help with both falling and staying asleep. But, as they are addictive, they are the last recommended treatment option.

Medications for treating insomnia include:

• Mirtazapine (Remeron)
• Zolpidem (Ambien)
• Ramelteon (Rozerem)
• Zaleplon (Sonata)
• Eszopiclone (Lunesta)
• Melatonin

The bottom line is if you’ve noticed any of the above-listed symptoms and suspect you may suffer from paradoxical insomnia, ensure you consult your doctor to discuss the best treatment option for you.