Subjective insomnia without objective findings: A pseudo diagnostic classification?

Abstract

Subjective insomnia is a complaint of insomnia that is not confirmed by objective sleep disturbance. The prevalence of the disorder has been reported to be 25% of all insomnia patients. If this estimate is correct, then the diagnosis and treatment of insomnia are complicated by a complaint that is difficult to identify without costly diagnostic procedures in specialized facilities. In the present article, I critically examine both the evidence on which the estimated prevalence rate was based and the procedures used to define the disorder. In general, I found that the relevant studies did not determine whether patients recognized that they had slept well in the laboratory, did not consider the relation between the number-of-nights data collected and the probability of a patient''s sleep disturbance not reflected in standard sleep measurements or carry out detailed screening for psychopathology. I argue that there is insufficient evidence to conclude that the disorder exists.