Subjective and Objective Performance in Patients with Persistent Insomnia

Abstract

Patients with persistent insomnia generally complain about impaired daytime performance, memory lapses, etc., but it has been difficult to document these impairments empirically. One possibility is that insomnia patients are more likely to be dissatisfied with their actual performance, even when they perform as well as normals. In order to test this hypothesis, 20 insomniacs and 20 normal sleepers were compared both as to their objective performance and their subjectively perceived performance on a computerized test battery with four tasks: reaction time, two memory tasks, and finger tapping. As predicted, the results showed no differences between insomniacs and controls on objective performance, but revealed significant differences on subjective measures of performance: insomniacs rated significantly lower on performance expectancy, performance evaluation, results compared to others, and results compared to own real capacity. Insomniacs also rated significantly higher on state anxiety than the controls and among insomniacs anxiety was associated with several aspects of both objective and subjective performance. Insomniacs also reported another way of coping with tiredness than the controls: instead of slowing down for a while, they keep pushing themselves at the same pace in spite of their tiredness. It is concluded that many insomniacs suffer from a kind of performance anxiety, which makes them reluctant to slow down when being tired, and which may possibly play a causal role in the progression from temporary to persistent insomnia.