The Sleep Expectation-Reality Gap: Exploring Discrepancies Between Perceived and Ideal Sleep Duration in Primary Care Patients.

Abstract

Objective: This study aimed to quantify the discrepancy between perceived and ideal sleep duration among primary care patients and identify demographic, lifestyle, and psychological factors associated with this expectation-reality gap.

Methods: A cross-sectional study was conducted with 300 adult primary care patients, who completed a survey assessing demographics, sleep perceptions, and insomnia severity (Insomnia Severity Index, ISI). Sleep discrepancy was defined as the difference between perceived and ideal sleep duration. Statistical analyses included Wilcoxon signed-rank tests, Spearman's correlations, and multiple linear regression to examine predictors of sleep discrepancy.

Results: Participants reported a mean perceived sleep duration of 6.39 ± 1.36 h, significantly lower than their ideal sleep duration of 8.07 ± 0.75 h (p < 0.001). A significant sleep discrepancy was found in 81.3% of participants, while only 2.0% exceeded their perceived sleep needs. Higher ISI scores were strongly associated with greater sleep discrepancy (r = -0.476, p < 0.001). The regression model explained 27.7% of the variance (p < 0.001), with insomnia severity (β = -0.425, p < 0.001), higher BMI (β = -0.192, p < 0.001), cola drink consumption (β = 0.142, p = 0.009), and older age (β = 0.163, p = 0.002) as significant predictors. Gender, hypnotic medication use, and alcohol intake were non-significant.

Conclusions: A substantial expectation-reality gap in sleep duration exists, linked to insomnia severity, older age, and lifestyle factors. Addressing maladaptive sleep expectations through cognitive-behavioral interventions in primary care may improve sleep satisfaction and reduce insomnia-related distress.