Scientists have found that paradoxical insomnia, also known as sleep state misperception, can alter the perception of consciousness and trick people into thinking they are asleep. This condition involves a disconnect between what patients experience as their total sleep time and what they can objectively measure as their real total sleep. This is different from traditional insomnia, where people with traditional insomnia estimate their sleep time. Factors such as genetics, mental health disorders (like PTSD, anxiety, or depression), or untreated sleep apnea could also be factors at play. Andrew R. Spector, a sleep medicine specialist at Duke Health, suggests that a more rigorous approach to sleep is effective. He also suggests that people with paradoxicalomnia have underlying anxiety, depression, or physical chronic pain.