• Introduction: Patients with sleep disorders often report sleep difficulties that contradict physiological data. This phenomenon, known as "sleep state misperception" or "paradoxical insomnia," reflects significant cognitive distortion regarding one's own sleep health and can exacerbate sleep-related anxiety.
• Methods: We conducted a retrospective analysis of 2,133 patients who underwent diagnostic PSG at the Sleep Center of the Department of Otorhinolaryngology (2019-2023). Subjective sleep parameters were collected via a post-sleep questionnaire administered the morning after the PSG. We compared subjective reports with objective data across key variables: Total Sleep Time (TST), Sleep Onset Latency (SOL), and the frequency of apnea/hypopnea events.
• Results: The analysis revealed significant discrepancies between perception and reality. Patients consistently demonstrated a negative bias regarding sleep continuity; they perceived their sleep duration as significantly shorter and sleep onset as taking longer compared to objective recordings. In contrast, a profound lack of awareness (anosognosia) was observed regarding sleep breathing disorders. While objective data indicated frequent apnea/hypopnea events (mean approx. 100/night), patients' subjective reports showed minimal awareness of these disruptions.
• Conclusions: Patients tend to "catastrophize" insomnia symptoms while remaining unaware of physical disruptions like sleep apnea. These findings suggest that sleep disorders involve not only physiological mechanisms but also significant cognitive distortions. Consequently, providing objective feedback based on PSG data is essential to correct patients' misperceptions and improve therapeutic outcomes.