Talking about subjective insomnia

  Mr. Zhang is an engineer who used to work in a large state-owned enterprise. After he retired, he developed insomnia symptoms and repeatedly sought treatment in various places, taking a lot of drugs and undergoing numerous tests. After several medication adjustments and psychological treatment, the patient said he would take the medication I prescribed and would not go out for medical treatment anymore. Although I was grateful to the doctor, I knew that the patient was still not satisfied with the treatment and with his sleep. Watching the patient, who left each time with some expectation, I myself was torn as to what the problem was.  At an outpatient clinic not long ago, the patient’s lover accompanied the consultation. When the patient complained to me that he was not sleeping well, his lover interjected from the side, “He sleeps better than I do every day, and he snores every night.” At this point I suddenly realized that the patient may have significant subjective insomnia.  The main clinical symptom of subjective insomnia, also known clinically as pseudosomnia, is that the objective sleep situation does not match the subjective one. The patient sleeps well objectively, but always exaggerates his or her difficulty in falling asleep, or in sleeping less. Since the patient is convinced, it is difficult to convince him/her by persuasion, so it is also considered as a delusion of insomnia. Clinically, it can be confirmed by sleep EEG to help patients eliminate their anxiety about sleep. Our hospital has recently introduced a device, based on sleep ECG coupling technology, which can easily measure the patient’s sleep at night. Sure enough, when the test results came back, the patient had a good quality of sleep. I felt a rare smile on the patient’s face when he looked at the objective data of his sleep.