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矛盾性失眠(paradoxical insomnia)是一种常见的临床现象，由于对其发病机制缺乏全面了解，导致诊断标准、治疗效果的差异性较大，从而干扰其流行病学资料的正确统计等。通过对既往研究的总结，结合自身针对慢性失眠症发病机制的研究，提出了矛盾性失眠的主、客观性评估差异与睡眠启动阶段丘脑-皮层失活非同步以及入睡后各区皮层激活序列、强弱紊乱有关，并根据其相关发病机制进行了诊断分型及临床特征描述，制定了具有针对性的治疗策略。矛盾性失眠是一种具有特殊病理生理机制的失眠类型。“,”Paradoxical insomnia is a common clinical phenomenon.Due to the lack of comprehensive understanding of its pathogenesis, there were wide variability in diagnostic criteria and treatment outcomes, thus interfering with the correct statistics of its epidemiological data.Through the summary of previous studies, combination with our own research on the pathogenesis of chronic insomnia, we propose that the differences in the subjective and objective assessment of paradoxical insomnia are related to the asynchronous inactivation of the thalamus and cortex during the sleep initiation phase and the cortical activation sequence and intensity disorders in each region after sleep.Furthermore, the diagnosis of paradoxical insomnia and clinical characteristics are described according to the related pathogenesis and a targeted treatment strategy is formulated.Paradoxical insomnia is a type of insomnia with specific pathophysiological mechanism.