This sleep disorder frequently applies when patients report not feeling tired despite their subjective perception of not having slept. Generally, they may describe experiencing several years of no sleep, short sleep, or non-restorative sleep. Otherwise, patients appear healthy, both psychiatrically and medically. (That this condition is often asymptomatic could explain why it is relatively unreported.)

However, upon clinical observation, it is found that patients may severely overestimate the time they took to fall asleep—often reporting having slept half the amount of time indicated by polysomnogram or electroencephalography (EEG), which may record normal sleep. Observing such discrepancy between subjective and objective reports, clinicians may conclude that the perception of poor sleep is primarily illusionary.

Alternatively, some people may report excessive daytime sleepiness or chronic disabling sleepiness, while no sleep disorder has been found to exist. Methods of diagnosing sleepiness objectively, such as the Multiple Sleep Latency Test do not confirm the symptom"true" sleepiness is not observed despite the complaint. (It may be speculated that such reports of daytime sleepiness may be a result of the nocebo response —the reverse of the placebo effect—due to patient expectations of adverse effects from their subjective perception of poor sleep.)

Finally, on the opposite end of the spectrum, other patients may report feeling that they have slept much longer than is observed. It has been proposed that this experience be subclassified under sleep state misperception as "positive sleep state misperception", "reverse sleep state misperception", and "negative sleep state misperception".

Sleep state misperception is classified as an intrinsic dyssomnia. While SSM is regarded a sub-type of insomnia, it is also established as a separate sleep-condition, with distinct pathophysiology. Nonetheless, the value of distinguishing this type of insomnia from other types is debatable due to the relatively low frequency of SSM being reported.

Sleep state misperception can also be further broken down into several types, by patients who—

- report short sleep (subjective insomnia complaint without objective findings)

- or no sleep at all (subjective "total" insomnia)

- report excessive daytime sleepiness (subjective sleepiness complaint without objective findings)

- report sleeping too much (subjective hypersomnia without objective findings)

Age: Adult and Elderly

Sex: Both

Onset : Subacute

Behavior change

Memory loss, confabulation

Confusion and disorientation

Hallucinations

Dyssomnia

Seizures focal and generalized, myoclonic

Extrapyramidal dysfunction

Brainstem/cranial nerve dysfunction

Dysautonomia

Neuromyotonia

Peripheral nerve dysfunction

Hyponatreamia

Movement Disorder

- Dystonia

- Parkinsonism

- Chorea

- Ocular flutter

- Motor tics

Psychiatric Symptoms

- Agitation

- Emotional lability

- Psychosis

- Depression

Associated symptoms

- Encephalopathy

- Sleep disorder

- Reduced consciousness

- Mutism