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A fascinating yet poorly understood disorder, paradoxical insomnia refers to a condition of gross discrepancy between objective sleep quantity per night and the subjective perception of sleep. Generally, people suffering from this condition complain bitterly, and sincerely, of not being able to sleep at all, yet when studied show sleep of normal duration and quality. Pathophysiology of paradoxical insomnia remains largely poorly understood. Increase in faster EEG activity during sleep and increase in physiological arousal seem to be prevalent in these patients, but whether they have direct causative impact remains to be seen. Management starts with education and other than psychotherapy no other techniques have been shown helpful.
KeywordsParadoxical insomnia Psychotherapy Fast EEG activity Physio-logical arousal
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