Sleep Misperception in Chronic Insomnia Patients with Obstructive Sleep Apnea Syndrome: Implications for Clinical Assessment

Su Jung Choi, Sooyeon Suh, Jason Ong, Eun Yeon Joo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Study Objectives: To investigate whether sleep perception (SP), defined by the ratio of subjective and objective total sleep time, and habitual sleep time in various sleep disorders may be based on comorbid insomnia status. Methods: We enrolled 420 patients (age 20-79 y) who underwent polysomnography (PSG). They were divided into three groups based on chief complaints: chronic insomnia (CI, n = 69), patients with both obstructive sleep apnea and insomnia (OSA-I, n = 49) or OSA only (OSA, n = 149). Healthy volunteers were also recruited (normal controls [NC], n = 80). We compared differences in PSG parameters and habitual sleep duration and investigated the discrepancy between objective and subjective total sleep time (TST) and sleep latency among four groups. Subjective TST was defined as sleep time perceived by participants the next morning of PSG. Results: SP for TST was highest in the OSA group (median 92.9%), and lowest in the CI group (80.3%). SP of the NC group (91.4%) was higher than the CI, but there was no difference between OSA-I and OSA groups. OSA-I had higher depressive mood compared to the OSA group (p < 0.001). SP was positively associated with the presence of OSA and habitual sleep duration and negatively related to the presence of insomnia and arousal index of PSG. Insomnia patients with (OSA-I) or without OSA (CI) reported the smallest discrepancy between habitual sleep duration and objective TST. Conclusions: Patients with OSA with or without insomnia have different PSG profiles, which suggests that objective measures of sleep are an important consideration for differentiating subtypes of insomnia and tailoring proper treatment. Commentary: A commentary on this articles appears in this issue on page 1437.

Original languageEnglish (US)
Pages (from-to)1517-1525
Number of pages9
JournalJournal of Clinical Sleep Medicine
Issue number11
StatePublished - 2016


  • Chronic insomnia
  • Obstructive sleep apnea
  • Sleep perception

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Sleep Misperception in Chronic Insomnia Patients with Obstructive Sleep Apnea Syndrome: Implications for Clinical Assessment'. Together they form a unique fingerprint.

Cite this