in this report, we discuss evidence for hyperarousal in insomnia and explore the role of sleep reactivity. in the current review, we will begin by briefly considering the literature on hyperarousal in insomnia, and then shift focus to explore a recent and quickly emerging area of insomnia research that is proving to be an integral component of the hyperarousal model of insomnia: sleep reactivity. in recent years, research has identified that a sleep-specific component of stress reactivity exists, and the degree to which stress reactivity manifests in the sleep system has been referred to as situational insomnia42 and, now more commonly, “sleep reactivity”.38 sleep reactivity is the degree to which individuals exhibit acute sleep disturbance in response to stress exposure.
further, evidence suggested that sleep reactivity predicted future insomnia independently of general trait hyperarousal, thus supporting sleep-specific stress reactivity as a unique factor that may be related to hyperarousal but is also a unique and independent insomnia risk factor. and even after insomnia remission, sleep reactivity did not return to preinsomnia baseline levels even after disease remission, indicating that stress exposure and insomnia development have a scarring effect on the sleep system. it is possible that the interbreeding between sleep reactivity and cognitive–emotional reactivity contributes significantly to the high comorbidity between insomnia and depression.76,77 significant strides in insomnia research over many decades have culminated in the hyperarousal hypothesis, which has been a robust framework for the conceptualization of insomnia etiology, and targets for intervention and prevention. the bidirectional relationship, comprising of a theorized positive feedback loop, between sleep reactivity and cognitive–emotional reactivity in response to stress.
hyperarousal is a 24-hour state of physical and mental tension. sleep reactivity is the term used to describe the extent to which sleep is affected by stressful events — and high sleep reactivity has been linked to a higher risk for insomnia. with that being said, we still don’t fully understand how hyperarousal and sleep reactivity affect insomnia severity, particularly as we age. their study was published in 2017 in the journal brain sciences. insomnia severity was measured using the french-canadian version of the insomnia severity index, arousal was measured using the arousal predisposition scale, and sleep reactivity was measured using the ford insomnia response to stress test.
researchers found that those with high arousal scores had significantly higher scores on the insomnia severity index compared to participants with lower arousal scores. similarly, those with high sleep reactivity scores reported significantly higher insomnia severity compared to those with low sleep reactivity scores. participants between the ages of 45-55 had significantly lower arousal scores compared to those between 25-35. although hyperarousal symptoms decreased with age, sleep reactivity remained the same across all age groups. cognitive behavioral therapy for insomnia has been linked to a reduction in sleep reactivity, meaning that this treatment option can help reduce the effect of stressful events on sleep. studies have also found that the thoughts and beliefs we have towards sleep can have a big influence on sleep quality. martin is the creator of insomnia coach, an eight-week course that combines online sleep education with individual sleep coaching.
hyperarousal is a key component in all modern etiological models of insomnia disorder. overall patterns in the literature suggest that hyperarousal, a state of excessive physical and mental tension, is risk factor for insomnia. learn how to reduce stress to prevent this anxiety is a component of hyperarousal, which can worsen insomnia. coping tools to reduce anxiety include mindfulness and dialectical, .
insomnia is often considered a disorder of hyperarousal; that is, the patient has a level of arousal that is incompatible with the initiation or maintenance of sleep. the concept of hyper- arousal is, however, likely to be quite complex. cognitive behavioral therapy for hyperarousal insomnia (cbt-i) directly addresses our thoughts and behaviors. it is a type of talking therapy that focuses on the hyperarousal state associated with primary insomnia is usually present throughout wakefulness and during sleep, and may be due to an increase in activity of interestingly, cortical hyperarousal is greatest in individuals with insomnia with short sleep duration and may explain the sleep complaints of those with, .
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