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Hyperarousal dynamics reveal an overnight increase boosted by insomnia.

Lara Rösler1, Erik-Jan van Kesteren2, Jeanne Leerssen1

  • 1Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, the Netherlands.

Journal of Psychiatric Research
|September 28, 2024
PubMed
Summary

Hyperarousal, a key insomnia symptom, fluctuates daily. Worse sleep quality amplifies overnight increases in hyperarousal, suggesting sleep improvement may help manage anxiety and stress disorders.

Keywords:
ActigraphyEcological momentary assessmentExploratory factor analysisHyperarousalInsomniaSleep quality

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Area of Science:

  • Psychology
  • Neuroscience
  • Sleep Medicine

Background:

  • Hyperarousal is a core symptom in anxiety, stress-related disorders, and insomnia.
  • Previous research conceptualized hyperarousal inconsistently, leading to mixed evidence.
  • The daily variability of hyperarousal and its link to sleep quality in insomnia remain understudied.

Purpose of the Study:

  • To investigate the daily dynamics of state hyperarousal in individuals with insomnia.
  • To explore the relationship between day-to-day variations in hyperarousal and subjective sleep quality.

Main Methods:

  • Employed ecological momentary assessment over 9 days in 169 individuals with insomnia and 38 controls.
  • Utilized exploratory factor analysis to identify a hyperarousal factor (tension, distress).
  • Applied adaptive LASSO regression to analyze the association between sleep quality and hyperarousal fluctuations.

Main Results:

  • A distinct hyperarousal factor was identified, with higher scores in the insomnia group.
  • Hyperarousal peaked in the morning and decreased throughout the day in both groups.
  • Individuals with insomnia exhibited a stronger overnight increase in hyperarousal, particularly after nights of poorer sleep quality.

Conclusions:

  • Subjective sleep quality is significantly associated with overnight modulations of hyperarousal.
  • The findings highlight the interplay between sleep and hyperarousal dynamics in insomnia.
  • Interventions targeting sleep quality may be beneficial for disorders characterized by hyperarousal.