You’re lying in bed. You’re frustrated because you can’t fall asleep. You look at the alarm clock and see that it is 1am. Then your brain wanders. You look at the clock again, which now reads 2am. You are certain you were awake during that hour...but in reality, you may have been drifting in and out of sleep without realizing it, thinking thoughts intermingled with dream fragments.
The phenomenon when you have the feeling you were awake when, in fact, you were actually asleep is called sleep state misperception, or paradoxical insomnia, and is very common among adults with insomnia. Sleep researchers can tell when it is occurring by looking at tracings of brain waves during a sleep study. Why does this happen? No one really knows for sure, but scientists suspect that it is related to the brain attempting to keep itself more alert, trying to attend to the surrounding environment. Additionally, there are times when we may have been drifting in and out of sleep, but our brain only perceives the time spent awake and erroneously jumps to the conclusion that we were continuously awake.
Sleep state misperception likely occurs as part of the general hyperarousal response to stress. This is a state in which the body increases its "fight or flight" hormone levels to stay more alert and able to respond more quickly to any impending threats during the day AND night. When we are under stress, our sleep can be naturally lighter, shorter and a bit more fragmented, allowing us to stay aware of our environment and any potential threats it poses.
While the hyperarousal state is not healthy, even when we are not stressed it is normal to spend some time awake during the night. The brain sleeps in 90-minute cycles and is supposed to wake up briefly between each cycle to check our surroundings. Sleep is also naturally deeper in the first half of the night: we wake up more even within a sleep cycle the closer we get to our regular wake-up time. It is considered normal to take up to 30 minutes to fall asleep at night and to awaken up 3 times during the night for 20 minutes per awakening (and more/longer awakenings may still be normal for some individuals ). Many people who think they are “great sleepers” are actually chronically sleep deprived and sleeping overly deeply. Taking a little bit of time to fall asleep and having a few awakenings during the night may actually be a sign that you are sufficiently well rested.
If you think you might be experiencing sleep state misperception, try these experiments:
Experiment 1: Imagine sitting upright and awake
If you wake up feeling like you’ve been awake for a significant period of time in bed, think about how you would feel spending that same amount of time fully awake, sitting upright, in a boring room. If the time awake in bed feels shorter than how you would perceive the same amount of time sitting upright and awake, reassure yourself that you likely did get some sleep during that time.
Experiment 2: Stop checking the clock
Studies show that checking the clock during the night actually causes increased sleep disruption and distress. If you have to wake up at a specific time, set an alarm (or two) for that time and place it across the room so you know you will be forced to get up and turn it off. Consider popping the window shade open slightly so you can check to see if sunlight is coming through the window or purchasing an alarm clock with a gentle wake-up light that starts to glow prior to your wake-up time.
It’s important to note: Checking the time on your phone is doubly bad because your brain automatically thinks about all the other content on the phone and becomes more stimulated than if you simply lay there resting. Additionally, many phones emit blue light which stimulates alertness pathways in the brain. Keep your phone out of the bedroom or across the room where you cannot access it.
Experiment 3: Stop worrying about not sleeping
Remind yourself that some time spent awake in bed is normal and is a sign that you are likely obtaining sufficient sleep. Take some deep breaths. Enjoy the quiet rest time. Let your mind wander through pleasant thoughts. Often once you stop trying to sleep, sleep just happens.
Experiment 4: Change the situation
If you find that you really are fully awake and getting anxious or stressed in bed, this is a sign that you need to get out of the bed and do something else for a short period of time. Distract your mind with something like reading a good book (a physical book, rather than reading on a device is optimal) for 30-60 minutes. Then return back to bed and let yourself rest and drift off to sleep.
After trying these experiments, if you still believe you're spending long periods of time in bed awake and your daytime performance or energy level is being negatively affected, talk to a sleep medicine specialist to see if there are additional steps you can take to get a good night’s sleep. Sleep is one of the pillars of health, alongside diet and physical activity, so make it a priority in your life.