Challenging subjective excessive daytime sleepiness as an insomnia symptom: a retrospective study

Patients with insomnia disorder (ID) reported levels of sleepiness comparable to healthy controls and significantly lower than those with excessive daytime sleepiness.

• Subjective sleepiness in patients with ID, measured by the Epworth Sleepiness Scale, did not correlate with daytime functioning.
• Insomnia severity and the impact of insomnia on daily life were significantly associated with reported fatigue.
• A significant increase in sleepiness was observed after cognitive behavioural therapy for insomnia (CBT-I), despite improvements in daytime functioning and fatigue.
• The findings suggest a dissociation between sleepiness and fatigue in patients with ID, challenging existing diagnostic criteria.

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