Patients with paradoxical insomnia often report spending hours lying awake at night, even though, to others, they appear to be sleeping. They overestimate the time it takes for them to fall asleep and underestimate their total sleep time.
Paradoxical insomniacs have an intense awareness of their surroundings throughout the entire night, as if they were awake. They might think they've gone without sleep for days at a time, but with only moderate signs of daytime fatigue.
A surprise diagnosis
"My nights were dreadful," says the marketing manager. "I felt like I was getting about three to five hours of sleep, and those were on 'good' nights. I felt OK during the day, but I did notice that I had a shorter attention span at work, and I forgot things easilyplaces I'd just eaten, or what movies I'd recently watched were about."
Watson assumed that her sleep study would reveal obstructive sleep apnea, since it ran in the family; her father had surgery to treat his.
At the hospital sleep center, Watson was wired with electrodes on her head and body, belts around her chest and abdomen, and a small clip on her fingertip.
The next morning, Watson felt completely sleep-deprivedbut the research doctor later informed her otherwise: "I was told that I slept seven hours. If you had asked me, I would have said two hours, because that's what it felt like. I was completely shocked."
She was also surprised to learn that her snoringthe result of a deviated septumwas not serious enough to obstruct her breathing or be considered sleep apnea. Her real problem, it turned out, was paradoxical insomnia.
Finding a solution
Watson was relieved to find out that there was a real explanation for her symptoms, and the diagnosis helped her doctor understand her condition better. They worked together, trying Tylenol PM, over-the-counter melatonin, and, when those weren't helpful, a variety of prescription sleep drugs. These have helped, but Watson is hoping that her next visit with a sleep specialist will improve her sleep even more.
While insomnia is the most common sleep problem in the U.S. (affecting an estimated 35% of the population), it's estimated that less than 5% of those cases can be considered paradoxical.
The American Academy of Sleep Medicine has more information on paradoxical insomnia and other uncommon sleep disorders at its patient website, SleepEducation.com. If you or your sleep partner are experiencing these symptoms, talk to a certified sleep specialist.