Insomnia differences were largest in people's reports of sleep
An umbrella review found larger, more consistent differences in reported sleep than in laboratory sleep measures, with only moderate overall confidence in the evidence.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
People with insomnia differed most consistently from healthy controls in how they described their sleep. Laboratory sleep measurements generally showed smaller differences, and objective attention and alertness differed little. This pattern describes the measures used across groups; it does not establish what causes an individual's insomnia or make their reported sleep difficulties less meaningful.
Reviewers rated overall confidence as moderate, identifying shortcomings in protocol preregistration and justification for including individual studies. This abstract-based account cannot specify those shortcomings further or quantify the reported differences.
Different measures capture different aspects
The review compared sleep diaries with laboratory sleep recordings and also considered cognition, blood pressure, brain activity and blood markers. Subjective sleep measures consistently showed larger effects than objective sleep measures in the included evidence.
What the objective findings mean
Among objective measures, the largest differences involved nonspecific stress markers, including cortisol and brain-derived neurotrophic factor. These marker differences do not themselves establish a clinical outcome, and the review does not identify a single mechanism explaining insomnia.
The original publication
Comparing subjective and objective nighttime- and daytime variables between patients with insomnia disorder and controls - a systematic umbrella review of meta-analyses.
Hertenstein E, Angelillo M, Henckaerts P et al.
Sleep Med Rev · 2025
- PubMed ID
- 40850055
- Record checked
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