Hyperarousal and sleep reactivity in insomnia: current insights

David A Kalmbach,1 Andrea S Cuamatzi-Castelan,1 Christine V Tonnu,1 Kieulinh Michelle Tran,1 Jason R Anderson,2 Thomas Roth,1 Christopher L Drake1 1Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA; 2Department of Psychological Sciences, Kent State Universit...

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Autores principales:	Kalmbach DA, Cuamatzi-Castelan AS, Tonnu CV, Tran KM, Anderson JR, Roth T, Drake CL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Insomnia Hyperarousal Stress Sleep Reactivity Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/4188fb5cd5cf4ebebd9d2c1f30afd8e5
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spelling	oai:doaj.org-article:4188fb5cd5cf4ebebd9d2c1f30afd8e52021-12-02T01:42:10ZHyperarousal and sleep reactivity in insomnia: current insights1179-1608https://doaj.org/article/4188fb5cd5cf4ebebd9d2c1f30afd8e52018-07-01T00:00:00Zhttps://www.dovepress.com/hyperarousal-and-sleep-reactivity-in-insomnia-current-insights-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608David A Kalmbach,1 Andrea S Cuamatzi-Castelan,1 Christine V Tonnu,1 Kieulinh Michelle Tran,1 Jason R Anderson,2 Thomas Roth,1 Christopher L Drake1 1Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA; 2Department of Psychological Sciences, Kent State University, Kent, OH, USA Abstract: Hyperarousal is a key component in all modern etiological models of insomnia disorder. Overall patterns in the literature suggest that over-active neurobiological and psychological systems contribute to difficulty sleeping. Even so, mixed results regarding the specific mechanisms linking hyperarousal to sleep disturbance limit current etiological conceptualizations. Similar basal arousal profiles between individuals with high vs low risk for insomnia in the absence of stress exposure suggest that dysregulated stress “response” rather than general hyperarousal may be a more pertinent marker of risk. In this report, we discuss evidence for hyperarousal in insomnia and explore the role of sleep reactivity. A trait characteristic, sleep reactivity is the degree to which stress disrupts sleep, manifesting as difficulty falling and staying asleep. Premorbid sleep reactivity has been shown to identify individuals at risk for future insomnia disorder, such as highly reactive sleepers (whose sleep systems are sensitive to stress) who are at elevated disease risk. Research points to genetics, family history of insomnia, gender, and environmental stress as factors that influence sleep reactivity. Importantly, stress-related cognitive–emotional reactivity (e.g., rumination, worry) may exploit the vulnerability of a highly reactive sleep system. We propose that sleep reactivity and cognitive–emotional reactivity may share a bidirectional relationship, conferring an insalubrious environment for sleep in response to stress. Future research on sleep reactivity is needed to identify its neurobiology, characterize its relationship with cognitive–emotional reactivity, and explore the potential clinical utility of sleep reactivity in treatment planning. Keywords: insomnia, hyperarousal, stress, sleep reactivityKalmbach DACuamatzi-Castelan ASTonnu CVTran KMAnderson JRRoth TDrake CLDove Medical PressarticleInsomniaHyperarousalStressSleep ReactivityPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 193-201 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Insomnia Hyperarousal Stress Sleep Reactivity Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Insomnia Hyperarousal Stress Sleep Reactivity Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Kalmbach DA Cuamatzi-Castelan AS Tonnu CV Tran KM Anderson JR Roth T Drake CL Hyperarousal and sleep reactivity in insomnia: current insights
description	David A Kalmbach,1 Andrea S Cuamatzi-Castelan,1 Christine V Tonnu,1 Kieulinh Michelle Tran,1 Jason R Anderson,2 Thomas Roth,1 Christopher L Drake1 1Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA; 2Department of Psychological Sciences, Kent State University, Kent, OH, USA Abstract: Hyperarousal is a key component in all modern etiological models of insomnia disorder. Overall patterns in the literature suggest that over-active neurobiological and psychological systems contribute to difficulty sleeping. Even so, mixed results regarding the specific mechanisms linking hyperarousal to sleep disturbance limit current etiological conceptualizations. Similar basal arousal profiles between individuals with high vs low risk for insomnia in the absence of stress exposure suggest that dysregulated stress “response” rather than general hyperarousal may be a more pertinent marker of risk. In this report, we discuss evidence for hyperarousal in insomnia and explore the role of sleep reactivity. A trait characteristic, sleep reactivity is the degree to which stress disrupts sleep, manifesting as difficulty falling and staying asleep. Premorbid sleep reactivity has been shown to identify individuals at risk for future insomnia disorder, such as highly reactive sleepers (whose sleep systems are sensitive to stress) who are at elevated disease risk. Research points to genetics, family history of insomnia, gender, and environmental stress as factors that influence sleep reactivity. Importantly, stress-related cognitive–emotional reactivity (e.g., rumination, worry) may exploit the vulnerability of a highly reactive sleep system. We propose that sleep reactivity and cognitive–emotional reactivity may share a bidirectional relationship, conferring an insalubrious environment for sleep in response to stress. Future research on sleep reactivity is needed to identify its neurobiology, characterize its relationship with cognitive–emotional reactivity, and explore the potential clinical utility of sleep reactivity in treatment planning. Keywords: insomnia, hyperarousal, stress, sleep reactivity
format	article
author	Kalmbach DA Cuamatzi-Castelan AS Tonnu CV Tran KM Anderson JR Roth T Drake CL
author_facet	Kalmbach DA Cuamatzi-Castelan AS Tonnu CV Tran KM Anderson JR Roth T Drake CL
author_sort	Kalmbach DA
title	Hyperarousal and sleep reactivity in insomnia: current insights
title_short	Hyperarousal and sleep reactivity in insomnia: current insights
title_full	Hyperarousal and sleep reactivity in insomnia: current insights
title_fullStr	Hyperarousal and sleep reactivity in insomnia: current insights
title_full_unstemmed	Hyperarousal and sleep reactivity in insomnia: current insights
title_sort	hyperarousal and sleep reactivity in insomnia: current insights
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/4188fb5cd5cf4ebebd9d2c1f30afd8e5
work_keys_str_mv	AT kalmbachda hyperarousalandsleepreactivityininsomniacurrentinsights AT cuamatzicastelanas hyperarousalandsleepreactivityininsomniacurrentinsights AT tonnucv hyperarousalandsleepreactivityininsomniacurrentinsights AT trankm hyperarousalandsleepreactivityininsomniacurrentinsights AT andersonjr hyperarousalandsleepreactivityininsomniacurrentinsights AT rotht hyperarousalandsleepreactivityininsomniacurrentinsights AT drakecl hyperarousalandsleepreactivityininsomniacurrentinsights
_version_	1718402890293313536

Hyperarousal and sleep reactivity in insomnia: current insights

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