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This type of analysis may benefit from larger populations to ensure adequate sampling of potential subpopulations, as well as repeated measures to determine whether state or trait factors may influence the mismatch. It will be particularly important to include patients with insomnia with a spectrum of objective sleep difficulty (based on metrics such as TST, sleep efficiency); patients with severe objective sleep disturbance were not well represented in the current cohort. From a diagnostic standpoint, when restricting http://www.selleckchem.com/products/sorafenib.html case definitions to the specific circumstance of a patient with insomnia complaints who has normal sleep architecture, it has been estimated that so-called paradoxical insomnia has a low prevalence of http://www.selleck.cn/products/i-bet-762.html and Fins, 1995; Edinger and Krystal, 2003; Edinger et?al., 2000; Fernandez-Mendoza et?al., 2011; Frankel et?al., 1976; Manconi et?al., 2010; Means et?al., 2003). Our results are in line with the findings reported in these studies, with respect to underestimation of TST. However, some studies (Manconi et?al., 2010) have shown a bimodal distribution of mismatch, with a population with extreme mismatch distinct from those with accurate perception or less severe mismatch. Mismatch may of http://www.selleckchem.com/products/Trichostatin-A.html course be part of the presentation of insomnia in general, most particularly evident in the paradoxical subtype where it is a hallmark and perhaps categorical rather than dimensional feature. However, it is also important to recognize that a continuum of misperception may also present in other forms of insomnia, including the most common subtype of psychophysiological insomnia. Recognition of mismatch has important implications from a diagnostic and therapeutic standpoint. Assessing a patient's subjective experience of sleep in the laboratory setting may provide useful information for the patient and treating providers, by informing the extent to which mismatch might be relevant to that individual. It is worth noting that subjective reporting of sleep duration may vary with time frame of recollection. One study showed that immediate report (morning diary) for seven consecutive days of objective sleep monitoring differed from a retrospective self-assessment completed at the end of the study in which subjects gave global estimates of the prior week (Fichten et?al., 2005). Specifically, the retrospective gestalt estimate showed an exaggeration compared with the average of the underestimations provided each morning for the prior week. One could speculate that this exaggeration reflects a trait of some patients with insomnia.