Neuroimaging Evidence of Hyperarousal in Insomnia: An Advanced Review

Insomnia has become the most prevalent sleep disorder in the world. The hyperarousal model is one of the main theories to explain the pathogenesis of insomnia disorder, and neuroimaging studies have provided important evidence to support this model. Although the findings vary, the overall results indicate that insomnia patients experience a condition of hyperarousal. We reviewed and summarized the related evidence from previous functional and structural neuroimaging studies of hyperarousal, which mainly showed enhanced local activity and interregional functional connectivity, increased metabolism, structural changes in gray matter, and altered white matter connectivity. Future research should further focus on cortical hyperarousal in different insomnia subtypes, unify the treatment criteria based on a sleep-staging interpretation, strictly control for the effects of age and gender, and advance the application of neuroimaging in the diagnosis and prognostic evaluation of insomnia. This article is categorized under: Psychology > Brain Function and Dysfunction Neuroscience > Clinical Neuroscience > Computation.