The essential feature of this disorder is a complaint of severe or nearly “total” insomnia that
greatly exceeds objective evidence of sleep disturbance and is not commensurate with the
reported degree of daytime deficit. Although paradoxical insomnia is best diagnosed with
concurrent PSG and self-reports, it can be presumptively diagnosed on clinical grounds
alone. To some extent, “misperception” of the severity of sleep disturbance may characterize
all insomnia disorders