Patients denying supine sleep in the laboratory were more likely to misperceive sleep position on PSG, with younger females under-reporting supine sleep, and overall agreement between self-reported and polysomnography-measured sleep position was only moderate.
Overall agreement between self-reported and PSG-measured sleep position categories was only moderate.
Patients who self-reported sleeping supine on the PSG night were highly accurate, but those who denied supine sleep were frequently incorrect.
Patients who reported not sleeping on their back during the PSG had significantly higher odds of sleep position misperception.
Younger patients and females were more likely to under-report supine sleep.
Body position was measured using a Grael position sensor with manual editing based on digital video when discrepant readings occurred.
Misperception of supine sleep position has clinical implications for PAP therapy implementation and positional therapy efficacy assessment.
This research suggests that people are not always accurate when reporting whether they sleep on their back (supine position) during a sleep study. The study examined nearly 1,000 patients at a sleep clinic and compared what they said about their sleeping position to what was actually recorded by sensors and video during their overnight sleep test. While people who said they did sleep on their back were almost always correct (93%), more than 4 in 10 people who said they did not sleep on their back actually did spend measurable time in that position — meaning they significantly underestimated their back-sleeping. Overall, the match between self-reported and objectively measured sleep positions was only 'moderate' by statistical standards. The study also found that certain groups of people were more prone to this misperception. Specifically, younger patients (under 55 years old) and women were more likely to underreport how much time they spent sleeping on their back. Patients who claimed they slept entirely off their back had 11 times greater odds of being wrong compared to those who acknowledged some back-sleeping. This research matters because sleep position affects the diagnosis and treatment of sleep disorders like obstructive sleep apnea, which is often worse when sleeping on the back. If patients or clinicians rely on self-reported sleep position to make decisions — such as whether a patient needs 'positional therapy' to avoid back-sleeping, or how to interpret a sleep study — inaccurate self-reporting could lead to suboptimal treatment choices. The findings suggest that clinicians should be cautious about taking patients' word alone when assessing back-sleeping, particularly in younger women.
Wilson D, Hollamby M, Skinner T, Hay K, Curtin D, Szollosi I. (2026). Misperception of supine sleep in the sleep laboratory: a retrospective review of self-reported versus polysomnography-measured sleep position.. Sleep & breathing = Schlaf & Atmung. https://doi.org/10.1007/s11325-025-03560-4