Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do with It?
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Nearly one-third of the population reports new onset or acute insomnia in a given year. Similarly, it is estimated that approximately 10% of the population endorses sleep initiation and maintenance problems consistent with diagnostic criteria for chronic insomnia. For decades, acute and chronic insomnia have been considered variations of the same condition or disorder, only really differentiated in terms of chronicity of symptoms (days/weeks versus months). Whether or not acute and chronic insomnia are part of the same phenomena is an important question, one that has yet to be empirically evaluated. The goal of the present theoretical review was to summarize the definitions of acute and chronic insomnia and discuss the role that hyperarousal may have in explaining how the pathophysiology of acute and chronic insomnia is likely different (i.e., what biopsychological factors precipitate and/or perpetuate acute insomnia, chronic insomnia, or both?).
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Insomnia is frequently associated with cognitive and somatic hyperarousal, including in autism.
“However, insomnia is frequently associated with cognitive (Kalmbach et al ., 2020; Vargas et al ., 2020) and somatic hyperarousal (Vargas et al ., 2020), including in autism (Baker et al ., 2019b; Richdale et al ., 2014).”
From ACT-i, an insomnia intervention for autistic adults: A pilot study (2023) · cites this paper as Vargas et al ., 2020
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Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Two-Process Model of Sleep Regulation
Binder, M. D., Hirokawa, N., & Windhorst, U. (2008) · Springer eBooks · doi:10.1007/978-3-540-29678-2_6166 · Cited by 3,895 · see citing works
Epidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743 · cited 1× · see citing works
“Prevalence rates as high as 30% have been reported when: Duration of illness is not taken into account, qualitative criteria are used for insomnia frequency, and/or when daytime impairment criteria are not used to define “caseness” [27,28].”
BackgroundThe Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology
Aziz, F., & Chaudhary, K. R. (2016) · Cardiorenal Medicine · doi:10.1159/000450796 · Cited by 3,285 · see citing works
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822 · cited 1× · see citing works
“, the average HPA axis stress response is between 45–60 minutes from start to finish [35,36]).”
BackgroundThe Concepts of Stress and Stress System Disorders: Overview of Physical and Behavioral Homeostasis
Chrousos, G. P. (1992) · JAMA · doi:10.1001/jama.1992.03480090092034 · Cited by 2,689 · see citing works
Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.262.11.1479 · Cited by 2,440 · see citing works
The International Classification of Sleep Disorders: Diagnostic and Coding Manual
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-5-413_1 · Cited by 2,416 · see citing works
Tononi, G., & Cirelli, C. (2014) · Neuron · doi:10.1016/j.neuron.2013.12.025 · Cited by 2,356 · see citing works
Epidemiologic Study of Sleep Disturbances and Psychiatric Disorders: An Opportunity for Prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.1989.03430110069030 · Cited by 2,252 · see citing works
The hyperarousal model of insomnia: A review of the concept and its evidence
Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., & Nissen, C. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.04.002 · Cited by 1,789 · cited 1× · see citing works
“With regard to nocturnal wakefulness, it is unclear whether the group differences in hyperarousal observed during sleep, such as increased EEG activity, metabolic rate, or hormonal secretion [49,50], are related to condition (i.”
BackgroundSelf-citationMORIN, C., LEBLANC, M., DALEY, M., GREGOIRE, J., & MERETTE, C. (2006) · Sleep Medicine · doi:10.1016/j.sleep.2005.08.008 · Cited by 1,191 · see citing works
Epidemiology of Insomnia, Depression, and Anxiety
Taylor, D. J., Lichstein, K. L., Durrence, H. H., Reidel, B. W., & Bush, A. J. (2005) · Sleep · doi:10.1093/sleep/28.11.1457 · Cited by 988 · cited 2× · see citing works
“The quantitative criteria applied to the definition of AI were those that are typically adopted for clinical research [13,16].”
MethodMorin, C. M., & Benca, R. (2012) · The Lancet · doi:10.1016/s0140-6736(11)60750-2 · Cited by 976 · see citing works
Buckley, T. M., & Schatzberg, A. F. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1056 · Cited by 964 · see citing works
Vgontzas, A. N., Bixler, E. O., Lin, H.-M., Prolo, P., Mastorakos, G., Vela-Bueno, A., Kales, A., & Chrousos, G. P. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.8.7778 · Cited by 884 · see citing works
Psychophysiological insomnia: the behavioural model and a neurocognitive perspective
PERLIS, M. L., GILES, D. E., MENDELSON, W. B., BOOTZIN, R. R., & WYATT, J. K. (1997) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1997.00045.x · Cited by 795 · cited 1× · see citing works
“An environmentally conditioned stimulus (CS) produces the conditioned response (CR) of insomnia [93,94].”
BackgroundSelf-citationInsomnia with objective short sleep duration: The most biologically severe phenotype of the disorder
Vgontzas, A. N., Fernandez-Mendoza, J., Liao, D., & Bixler, E. O. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2012.09.005 · Cited by 776 · see citing works
Functional Neuroimaging Evidence for Hyperarousal in Insomnia
Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.11.2126 · Cited by 752 · cited 1× · see citing works
“Examples of central nervous system measures include power spectral measures of high frequency electroencephalogram (EEG) activity [51,53,54], EEG-based evoked response potential measures [55,56], imaging measures of brain glucose or oxygen utilization [57], and/or neuroimaging measures of GABA [25,58,59].”
BackgroundEspie, C. A. (2002) · Annual Review of Psychology · doi:10.1146/annurev.psych.53.100901.135243 · Cited by 596 · cited 1× · see citing works
“Thus, it may be the case that AI is precipitated by hyperarousal and that CI is perpetuated, to some extent by tonic activation of the fight/flight system, but in larger measure by conditioned wakefulness and/or the failure to inhibit wakefulness [92].”
BackgroundInternational Classification of Diseases (ICD)
Owens, D. L., & Owenby, B. (2016) · The SAGE Encyclopedia of Marriage, Family, and Couples Counseling · doi:10.4135/9781483369532.n271 · Cited by 563 · see citing works
24-Hour Metabolic Rate in Insomniacs and Matched Normal Sleepers
Bonnet, M. H., & Arand, D. L. (1995) · Sleep · doi:10.1093/sleep/18.7.581 · Cited by 557 · see citing works
The Natural History of Insomnia: A Population-Based 3-Year Longitudinal Study
Morin, C. M., Bélanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A., Mérette, C., Baillargeon, L., & Grégoire, J.-P. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.610 · Cited by 498 · see citing works
Bracha, H. S. (2004) · CNS Spectrums · doi:10.1017/s1092852900001954 · Cited by 497 · see citing works
Beta/Gamma EEG Activity in Patients with Primary and Secondary Insomnia and Good Sleeper Controls
Perlis, M. L., Smith, M. T., Andrews, P. J., Orff, H. J., & Giles, D. E. (2001) · SLEEP · doi:10.1093/sleep/24.1.110 · Cited by 493 · see citing works
Self-citationIncidence and Risk Factors of Insomnia in a Population-Based Sample
LeBlanc, M., Mérette, C., Savard, J., Ivers, H., Baillargeon, L., & Morin, C. M. (2009) · Sleep · doi:10.1093/sleep/32.8.1027 · Cited by 493 · see citing works
STRESSORS AND MOOD MEASURED ON A MOMENTARY BASIS ARE ASSOCIATED WITH SALIVARY CORTISOL SECRETION
Smyth, J. M., Ockenfels, M. C., Porter, L. S., Kirschbaum, C., Hellhammer, D. H., & Stone, A. A. (1998) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(98)00008-0 · Cited by 468 · see citing works
Heart Rate Variability in Insomniacs and Matched Normal Sleepers
Bonnet, M. H., & Arand, D. L. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199809000-00017 · Cited by 451 · see citing works
The effects of acute stress on episodic memory: A meta-analysis and integrative review.
Shields, G. S., Sazma, M. A., McCullough, A. M., & Yonelinas, A. P. (2017) · Psychological Bulletin · doi:10.1037/bul0000100 · Cited by 450 · see citing works
Germain, A., Buysse, D. J., & Nofzinger, E. (2008) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2007.09.003 · Cited by 421 · see citing works
Monjan, Simonsick, & Wallace (1999) · SLEEP · Cited by 401 · see citing works
Chronic insomnia and activity of the stress system
Vgontzas, A. N., Tsigos, C., Bixler, E. O., Stratakis, C. A., Zachman, K., Kales, A., Vela-Bueno, A., & Chrousos, G. P. (1998) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(97)00302-4 · Cited by 401 · see citing works
Regulation of the Hypothalamic-Pituitary-Adrenal Axis
Papadimitriou, A., & Priftis, K. Ν. (2009) · NeuroImmunoModulation · doi:10.1159/000216184 · Cited by 367 · see citing works
Sleep Disorders Classification Committee, Association of Sleep Disorders Centers
Howard, P. R. (1979) · SLEEP · doi:10.1093/sleep/2.1.1 · Cited by 359 · see citing works
Insomnia: Epidemiology, characteristics, and consequences
Roth, T. G., & Roehrs, T. (2003) · Clinical cornerstone · doi:10.1016/s1098-3597(03)90031-7 · Cited by 358 · see citing works
Beta EEG activity and insomnia
Perlis, M. L., Merica, H., Smith, M. T., & Giles, D. E. (2001) · Sleep Medicine Reviews · doi:10.1053/smrv.2001.0151 · Cited by 345 · see citing works
Self-citationSpectral characteristics of sleep EEG in chronic insomnia
Merica, H., Blois, R., & Jm, G. (1998) · European Journal of Neuroscience · doi:10.1046/j.1460-9568.1998.00189.x · Cited by 345 · see citing works
Is Insomnia a Perpetuating Factor for Late-Life Depression in the IMPACT Cohort?
Pigeon, W. R., Hegel, M. T., Unützer, J., Fan, M., Sateia, M. J., Lyness, J. M., Phillips, C., & Perlis, M. L. (2008) · SLEEP · doi:10.1093/sleep/31.4.481 · Cited by 320 · see citing works
Self-citationDaytime Alertness in Patients with Chronic Insomnia Compared with Asymptomatic Control Subjects
Stepanski, E. J., Zorick, F. J., Roehrs, T., Young, D. K., & Roth, T. G. (1988) · SLEEP · doi:10.1093/sleep/11.1.54 · Cited by 303 · see citing works
Effect of Chronic Stress Associated With Unemployment on Salivary Cortisol
Ockenfels, M. C., Porter, L. S., Smyth, J. M., Kirschbaum, C., Hellhammer, D. H., & Stone, A. A. (1995) · Psychosomatic Medicine · doi:10.1097/00006842-199509000-00008 · Cited by 298 · see citing works
Datta, S., & MacLean, R. R. (2007) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2007.02.004 · Cited by 296 · see citing works
Sleep disturbances are correlated with decreased morning awakening salivary cortisol
Backhaus, J., Junghanns, K., & Hohagen, F. (2004) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2004.01.010 · Cited by 287 · see citing works
The relationship between insomnia and body temperatures
Lack, L. C., Gradisar, M., Van Someren, E. J. W., Wright, H. R., & Lushington, K. (2008) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2008.02.003 · Cited by 285 · see citing works
Stimulus Control Treatment for Insomnia
Bootzin, R. R. (1973) · PsycEXTRA Dataset · doi:10.1037/e465522008-198 · Cited by 279 · see citing works
INSOMNIA: SYMPTOM OR DIAGNOSIS?
Harvey, A. G. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(00)00083-0 · Cited by 274 · see citing works
Nocturnal catecholamines and immune function in insomniacs, depressed patients, and control subjects
Irwin, M., Clark, C., Kennedy, B., Christian Gillin, J., & Ziegler, M. (2003) · Brain Behavior and Immunity · doi:10.1016/s0889-1591(03)00031-x · Cited by 268 · see citing works
Romero, L. M., & Butler, L. K. (2007) · International Journal of Comparative Psychology · doi:10.46867/ijcp.2007.20.02.15 · Cited by 267 · see citing works
Rodenbeck, A., Huether, G., Rüther, E., & Hajak, G. (2002) · Neuroscience Letters · doi:10.1016/s0304-3940(02)00192-1 · Cited by 265 · see citing works
Backhaus, J., Junghanns, K., Born, J., Hohaus, K., Faasch, F., & Hohagen, F. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.051 · Cited by 265 · see citing works
Dhabhar, F. S., McEwen, B. S., & Spencer, R. L. (2008) · Neuroendocrinology · doi:10.1159/000127196 · Cited by 259 · see citing works
Foley, D. J., Monjan, A. A., Simonsick, E. M., Wallace, R. B., & Blazer, D. G. (1999) · PubMed · Cited by 254 · see citing works
Chung, K.-F., Yeung, W.-F., Ho, F. Y.-Y., Yung, K.-P., Yu, Y.-M., & Kwok, C.-W. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2014.10.018 · Cited by 226 · see citing works
Orexin, stress, and anxiety/panic states
Johnson, P. L., Molosh, A. I., Fitz, S. D., Truitt, W. A., & Shekhar, A. (2012) · Progress in brain research · doi:10.1016/b978-0-444-59489-1.00009-4 · Cited by 220 · see citing works
Winkelman, J. W., Buxton, O. M., Jensen, J. E., Benson, K. L., O'Connor, S. P., Wang, W., & Renshaw, P. F. (2008) · SLEEP · doi:10.1093/sleep/31.11.1499 · Cited by 209 · see citing works
Nocturnal cortisol and melatonin secretion in primary insomnia
Riemann, D., Klein, T., Rodenbeck, A., Feige, B., Horny, A., Hummel, R., Weske, G., Al-Shajlawi, A., & Voderholzer, U. (2002) · Psychiatry Research · doi:10.1016/s0165-1781(02)00249-4 · Cited by 202 · see citing works
Jacobs, N., Myin‐Germeys, I., Derom, C. A., Delespaul, P., van Os, J., & Nicolson, N. A. (2006) · Biological Psychology · doi:10.1016/j.biopsycho.2006.07.002 · Cited by 200 · see citing works
The cortisol awakening response – Applications and implications for sleep medicine
Elder, G. J., Wetherell, M. A., Barclay, N. L., & Ellis, J. G. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2013.05.001 · Cited by 190 · see citing works
Self-citationIncreased EEG sigma and beta power during NREM sleep in primary insomnia
Spiegelhalder, K., Regen, W., Feige, B., Holz, J., Piosczyk, H., Baglioni, C., Riemann, D. W., & Nissen, C. (2012) · Biological Psychology · doi:10.1016/j.biopsycho.2012.08.009 · Cited by 185 · see citing works
A neurobiological model of insomnia
Buysse, D. J., Germain, A., Hall, M. H., Monk, T. H., & Nofzinger, E. A. (2011) · Drug Discovery Today Disease Models · doi:10.1016/j.ddmod.2011.07.002 · Cited by 180 · see citing works
The natural history of insomnia: Focus on prevalence and incidence of acute insomnia
Ellis, J. G., Perlis, M. L., Neale, L., Espie, C. A., & Bastien, C. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.07.001 · Cited by 178 · see citing works
Self-citationNeural Regulation of the Stress Response: The Many Faces of Feedback
Myers, B., McKlveen, J. M., & Herman, J. P. (2012) · Cellular and Molecular Neurobiology · doi:10.1007/s10571-012-9801-y · Cited by 175 · cited 1× · see citing works
“Put differently, most human stress systems in the body are self-regulating, which prohibits them from staying “on” for extended periods of time [37,38].”
BackgroundSlow dissolving of emotional distress contributes to hyperarousal
Wassing, R., Benjamins, J. S., Dekker, K., Moens, S., Spiegelhalder, K., Feige, B., Riemann, D., van der Sluis, S., Van Der Werf, Y. D., Talamini, L. M., et al. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1522520113 · Cited by 174 · see citing works
Acute insomnia: Current conceptualizations and future directions
Ellis, J. G., Gehrman, P., Espie, C. A., Riemann, D., & Perlis, M. L. (2012) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2011.02.002 · Cited by 170 · see citing works
Self-citationPlante, D. T., Jensen, J. E., Schoerning, L., & Winkelman, J. W. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2012.4 · Cited by 161 · see citing works
Lamarche, C. H., & Ogilvie, R. D. (1997) · SLEEP · doi:10.1093/sleep/20.9.726 · Cited by 160 · see citing works
Romero, L. M., & Butler, L. K. (2007) · International Journal of Comparative Psychology · Cited by 143 · see citing works
The EEG of the sleep onset period in insomnia: A discriminant analysis
Merica, H., & Gaillard, J. (1992) · Physiology & Behavior · doi:10.1016/0031-9384(92)90258-4 · Cited by 140 · see citing works
Zhang, J., Ronald, C. W., Kong, A. P. S., So, W. Y., Li, A. M., Lam, S. P., Li, S. X., Yu, M. W. M., Ho, C. S., Chan, M. H. M., et al. (2011) · SLEEP · doi:10.1093/sleep/34.2.225 · Cited by 136 · see citing works
Perlis, M. L., Shaw, P. J., Cano, G., & Espie, C. A. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4160-6645-3.00078-5 · Cited by 135 · see citing works
Self-citationDisturbed Sleep While Being On-Call: An EEG Study of Ships' Engineers
Torsvall, L., & Åkerstedt, T. (1988) · SLEEP · doi:10.1093/sleep/11.1.35 · Cited by 108 · see citing works
Perlis, M. L., Vargas, I., Ellis, J. G., Grandner, M. A., Morales, K. H., Gencarelli, A., Khader, W., Kloss, J. D., Gooneratne, N. S., & Thase, M. E. (2019) · SLEEP · doi:10.1093/sleep/zsz299 · Cited by 108 · see citing works
Self-citationSleep characteristics as predictor variables of stress systems markers in insomnia disorder
Floam, S., Simpson, N., Nemeth, E., Scott‐Sutherland, J., Gautam, S., & Haack, M. (2015) · Journal of Sleep Research · doi:10.1111/jsr.12259 · Cited by 103 · see citing works
Varkevisser, M., Dongen, H. P. A. V., & KERKHOF, G. A. (2005) · SLEEP · doi:10.1093/sleep/28.12.1588 · Cited by 95 · see citing works
(2005) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26373 · Cited by 90 · see citing works
Zhang, J., Lam, S.-P., Li, S. X., Ronald, C. W., Kong, A. P. S., Chan, M. H. M., Ho, C. S., Li, A. M., & Wing, Y. K. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-3728 · Cited by 84 · see citing works
MSLT in primary insomnia: stability and relation to nocturnal sleep
Roehrs, T. A., Randall, S., Harris, E., Maan, R., & Roth, T. (2011) · SLEEP · doi:10.5665/sleep.1426 · Cited by 84 · see citing works
Xia, L., Chen, G.-H., Li, Z.-H., Jiang, S., & Shen, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071065 · Cited by 83 · see citing works
Heart rate changes in chronic insomnia
Stepanski, E. J., Glinn, M. A., Zorick, F. J., Roehrs, T., & Roth, T. G. (1994) · Stress Medicine · doi:10.1002/smi.2460100409 · Cited by 82 · see citing works
Jones, M. T., TIPTAFT, E. M., Brush, F. R., FERGUSSON, D. A. N., & Neame, R. (1974) · Journal of Endocrinology · doi:10.1677/joe.0.0600223 · Cited by 79 · see citing works
Overnight worsening of emotional distress indicates maladaptive sleep in insomnia
Wassing, R., Benjamins, J. S., Talamini, L. M., Schalkwijk, F., & Van Someren, E. J. W. (2019) · Sleep · doi:10.1093/sleep/zsy268 · Cited by 78 · see citing works
Altered ultradian cortisol rhythmicity as a potential neurobiologic substrate for chronic insomnia
Vargas, I., Vgontzas, A., Abelson, J., Faghih, R., Morales, K., & Perlis, M. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.03.003 · Cited by 74 · see citing works
Self-citationOsuch, E. A., Willis, M. W., Bluhm, R., Ursano, R. J., & Drevets, W. C. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.03.010 · Cited by 67 · see citing works
The mesograde amnesia of sleep may be attenuated in subjects with primary insomnia
Perlis, M. L., Smith, M. T., Orff, H. J., Andrews, P. J., & Giles, D. E. (2001) · Physiology & Behavior · doi:10.1016/s0031-9384(01)00545-5 · Cited by 52 · see citing works
Self-citationQuality of Sleep and P300 Amplitude in Primary Insomnia: a Preliminary Study
Devoto, A., Manganelli, S., Lucidi, F., Lombardo, C., Russo, P. M., & Violani, C. (2005) · SLEEP · doi:10.1093/sleep/28.7.859 · Cited by 52 · see citing works
The Role of GABA in Primary Insomnia
Plante, D. T., Jensen, J. E., & Winkelman, J. W. (2012) · SLEEP · doi:10.5665/sleep.1854 · Cited by 51 · see citing works
The natural history of insomnia in the Ibadan study of ageing.
Gureje, O., Oladeji, B., Abiona, T., Makanjuola, V., & Esan, O. (2011) · Sleep · doi:10.5665/sleep.1138 · Cited by 48 · see citing works
P300 amplitude in subjects with primary insomnia is modulated by their sleep quality
Devoto, A., Violani, C., Lucidi, F., & Lombardo, C. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00579-2 · Cited by 45 · see citing works
The Role of Daily Activities in Youths' Stress Physiology
McHale, S. M., Blocklin, M. K., Walter, K. N., Davis, K. D., Almeida, D. M., & Klein, L. C. (2012) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2012.03.016 · Cited by 40 · see citing works
Electrodermal activity in patients with persistent insomnia
Broman, J., & Hetta, J. E. (1994) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1994.tb00124.x · Cited by 32 · see citing works
The diagnostic interview and differential diagnosis for complaints of insomnia.
Spielman, A. J., & Glovinsky, P. B. (1997) · American Psychological Association eBooks · doi:10.1037/10233-006 · Cited by 31 · see citing works
Neurobiologic Mechanisms in Chronic Insomnia
Perlis, M. L., Gehrman, P. R., Pigeon, W. R., Findley, J., & Drummond, S. P. A. (2009) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2009.07.002 · Cited by 29 · see citing works
Self-citationSleep at sea: a diary study of the effects of unattended machinery space watch duty
Torsvall, L., Castenfors, K., Åkerstedt, T., & Fröberg, J. E. (1987) · Ergonomics · doi:10.1080/00140138708966027 · Cited by 29 · see citing works
Spiegelhalder, K., & Riemann, D. W. (2013) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2013.04.008 · Cited by 22 · see citing works
Hyperarousal as the Basis for Insomnia: Effect Size and Significance
Bonnet, M. H. (2005) · SLEEP · doi:10.1093/sleep/28.12.1500 · Cited by 19 · see citing works
The physiology of sleep: homeostasis and health
Cook, N. F. (2010) · British Journal of Wellbeing · doi:10.12968/bjow.2010.1.8.80009 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [7]Spielman A.J. Glovinsky P.B. The varied nature of insomnia Case Studies in Insomnia Springer Boston, MA, USA 1991 1 18
- [20]American Academy of Sleep Medicine International Classification of Sleep Disorders—Third Edition (ICSD-3) American Academy of Sleep Medicine Darien, IL, USA 2014
- [77]Nofzinger E.A. Buysse D.J. Germain A. Price J. Miewald J. Kupfer D.J. Insomnia: Functional neuroimaging evidence for hyperarousal Sleep 2004 27 272 10.1176/appi.ajp.161.11.2126 15514418 · DOI · Paper page
Cited by
Sorted by citations
Hyperarousal in insomnia disorder: Current evidence and potential mechanisms
Dressle, R. J., & Riemann, D. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13928 · Cited by 218 · see citing works
Meaklim, H., Junge, M. F., Varma, P., Finck, W. A., & Jackson, M. L. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9354 · Cited by 74 · see citing works
Autonomic dysregulation and sleep homeostasis in insomnia
Grimaldi, D., Reid, K. J., Papalambros, N. A., Braun, R., Malkani, R. G., Abbott, S. M., Ong, J. C., & Zee, P. C. (2020) · SLEEP · doi:10.1093/sleep/zsaa274 · Cited by 60 · see citing works
Mechanisms of cognitive behavioural therapy for insomnia
Altena, E., Ellis, J. G., Camart, N., Guichard, K., & Bastien, C. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13860 · Cited by 52 · see citing works
Self-citationCardis, R., Lecci, S., Fernandez, L. M. J., Osorio-Forero, A., Chung, P. C. S., Fulda, S., Décosterd, I., & Lüthi, A. (2021) · eLife · doi:10.7554/elife.65835 · Cited by 49 · see citing works
The Effect of Bright Light Therapy on Sleep and Quality of Life in Patients With Poststroke Insomnia
Kim, W.-H., Joa, K.-L., Kim, C.-B., Lee, H.-S., Kang, S.-G., Jung, H.-Y., & Bae, J. N. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001014 · Cited by 42 · see citing works
Dressle, R. J., Riemann, D. W., Spiegelhalder, K., Frase, L., Perlis, M. L., & Feige, B. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13861 · Cited by 35 · see citing works
Self-citationPuyvelde, M. V., Cutsem, J. V., Lacroix, E., & Pattyn, N. (2021) · Military Medicine · doi:10.1093/milmed/usab398 · Cited by 23 · see citing works
Walker, J. L., Vargas, I., Drake, C. L., Ellis, J. G., Muench, A., & Perlis, M. L. (2022) · SLEEP · doi:10.1093/sleep/zsac149 · Cited by 30 · see citing works
Self-citationHyperarousal features in the sleep architecture of individuals with and without insomnia
Marco, T. D., Scammell, T. E., Sadeghi, K., Datta, A., Little, D., Tjiptarto, N., Djonlagic, I. E., Olivieri, A., Zammit, G. K., Krystal, A. D., et al. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14256 · Cited by 28 · see citing works
2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association
Drager, L. F., Assis, M., Bacelar, A. F. R., Poyares, D. L. R., Conway, S. G., Pires, G. N., de Azevedo, A. P., Carissimi, A., Eckeli, A. L., Pentagna, Á., et al. (2023) · Sleep Science · doi:10.1055/s-0043-1776281 · Cited by 25 · see citing works
Wu, P., Wang, C., Wei, M., Li, Y., Xue, Y., Li, X., Jiang, J., Bi, Y., Dai, J., & Jiang, W. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1277690 · Cited by 22 · see citing works
Yang, S., Tian, Y., He, Q., Qiu, J., Feng, T., Chen, H., & Lei, X. (2021) · Neuroscience · doi:10.1016/j.neuroscience.2021.05.014 · Cited by 17 · see citing works
ACT-i, an insomnia intervention for autistic adults: A pilot study
Lawson, L. P., Richdale, A. L., Denney, K., & Morris, E. M. J. (2023) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465822000571 · Cited by 13 · see citing works
“However, insomnia is frequently associated with cognitive (Kalmbach et al., 2020; Vargas et al., 2020) and somatic hyperarousal (Vargas et al.”
Hyperhidrosis in sleep disorders – A narrative review of mechanisms and clinical significance
Idiáquez, J., Casar, J. C., Arnardóttir, E. S., August, E., Santín, J., & Iturriaga, R. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13660 · Cited by 16 · see citing works
A Comprehensive Review of Lemborexant to Treat Insomnia
Fuller, M. C., Carlson, S. F., Grant, C., Berry, V., Ivancich, M. S., Cornett, E. M., Kaye, A. M., Viswanath, O., Urits, I., Shekoohi, S., et al. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4483 · Cited by 11 · see citing works
Starr, L. T., Washington, K. T., McPhillips, M., Pitzer, K., Demiris, G., & Oliver, D. P. (2022) · Palliative Medicine · doi:10.1177/02692163221122956 · Cited by 10 · see citing works
Meaklim, H., Junge, M. F., Varma, P., Finck, W. A., & Jackson, M. L. (2023) · Behavioral Sleep Medicine · doi:10.1080/15402002.2022.2074996 · Cited by 9 · see citing works
The psychometric properties of the Turkish version of the Pre-sleep Arousal Scale
Türkarslan, K. K., Çınarbaş, D. C., & Nicassio, P. M. (2023) · Sleep and Biological Rhythms · doi:10.1007/s41105-023-00483-z · Cited by 10 · see citing works
Management of patients with insomnia and polymorbidity: expert consensus
Poluektov, M. G., Akarachkova, E. S., Dovgan, E. V., Котова, О. В., Demidova, T. Y., Клименко, А. А., Kokorin, K. V. A., Ostroumova, O. D., & Оstroumova, Т. М. (2023) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202312305249 · Cited by 9 · see citing works
The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review
Holland-Winkler, A. M., Greene, D. R., & Oberther, T. J. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082169 · Cited by 9 · see citing works
Li, L., Wu, X., Gong, J., Wang, Z., Dai, W., Li, Q., Zuo, H., Yi, M., Yuan, H., Hu, M., et al. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1389768 · Cited by 6 · see citing works
Temporal relations between peripheral and central arousals in good and poor sleepers
Ribeiro, A. C. D. M., Gabriel, R., Garcia, B., Cuccio, C., Aqeel, W., Moreno, A., Landeen, C., Hurley, A., Kavey, N. B., & Pfaff, D. W. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2201143119 · Cited by 6 · see citing works
Examining the relation between oral contraceptive use and attentional engagement in everyday life
Smith, A. C., Marty-Dugas, J., & Smilek, D. (2023) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2023.1147515 · Cited by 6 · see citing works
Insomnia symptoms and risk for atrial fibrillation – The HUNT study
Gémes, K., Malmo, V., Strand, L. B., Ellekjær, H., Loennechen, J. P., Janszky, I., & Laugsand, L. E. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14156 · Cited by 6 · see citing works
Chen, N., Xia, Y., Wu, W., Chen, S., Zhao, M., Song, Y., & Liu, Y. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1400334 · Cited by 5 · see citing works
Does Insomnia Exist without Hyperarousal? What Else Can There Be?
Bastien, C. (2020) · Brain Sciences · doi:10.3390/brainsci10040225 · Cited by 5 · see citing works
Self-citationPsychophysiological Mechanisms of CBT‐I
Altena, E. (2022) · doi:10.1002/9781119891192.ch4 · Cited by 5 · see citing works
Picard, K., Dolhan, K., Watters, J. J., & Tremblay, M. (2024) · Advances in neurobiology · doi:10.1007/978-3-031-55529-9_20 · Cited by 4 · see citing works
“No rest for me tonight”: A social-ecological exploration of insomnia in rural Appalachian women
Moloney, M., Moga, D. C., Grandner, M. A., & Schoenberg, N. E. (2025) · Sleep Health · doi:10.1016/j.sleh.2025.04.009 · Cited by 3 · see citing works
Rasch analysis of the pre-sleep arousal scale in patients with acute insomnia disorder
Wu, A., Pu, Y., Zhao, Y., Luo, X., Fang, L., & Zhang, B. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.05.022 · Cited by 3 · see citing works
Sadikova, E., & Mazurek, M. O. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06321-6 · Cited by 3 · see citing works
Türkarslan, K. K., Çınarbaş, D. C., & Perogamvros, L. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10442-0 · Cited by 3 · see citing works
Sleep Dysfunction in Older Age Parkinson’s Disease
Matar, E., Lazcano‐Ocampo, C., & Padmakumar, C. (2025) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2025.05.005 · Cited by 2 · see citing works
Flo, E., Elvegaard, T., Gulla, C., & Husebo, B. S. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02317-4 · Cited by 2 · see citing works
Martin‐Willett, R., Master, A., Bidwell, L. C., & Sznitman, S. R. (2022) · Springer eBooks · doi:10.1007/978-3-030-67928-6_70-1 · Cited by 2 · see citing works
Orexants, Orexin Receptor Antagonists: Novel Therapeutic Agents for Insomnia Disorder
Kandukuri, A., Pasupulati, H., & Padi, S. S. (2024) · International Neuropsychiatric Disease Journal · doi:10.9734/indj/2024/v21i6457 · Cited by 1 · see citing works
Pretorius, T. B., & Padmanabhanunni, A. (2025) · Frontiers in Sleep · doi:10.3389/frsle.2025.1635434 · Cited by 1 · see citing works
Pretorius, T. B., & Padmanabhanunni, A. (2025) · OBM Neurobiology · doi:10.21926/obm.neurobiol.2504308 · Cited by 1 · see citing works
Insomnia severity and its association with gaming behavior and perceived health in autistic adults
Bouder, S., McNulty, L. K., & Lee, D. (2025) · BMC Psychology · doi:10.1186/s40359-025-03851-1 · Cited by 1 · see citing works
Luo, J., & Chen, Q. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1736601 · Cited by 1 · see citing works
Krystal, A. D., Benca, R. M., McCall, W. V., Perlis, M. L., Watson, N. F., Winkelman, J. W., Fisher, M., & Morin, C. M. (2026) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2026.102246 · Cited by 1 · see citing works
Self-citationRiemann, D. W., Baglioni, C., Nissen, C., Nevière, A., Irfan, O., Nouveau, P. L., Leontiou, C., & Léger, D. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70352 · Cited by 1 · see citing works
Stearns, M. A., Curtis, A. F., Roth, A. J., & McCrae, C. S. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00051-7
Nguyen, A., Campbell, R. L., Vance, A., & Leen‐Feldner, E. W. (2021) · SLEEP · doi:10.1093/sleep/zsab072.112
Self-citationHealth disparities and insomnia
Vargas, I., Walker, J. L., Egeler, M. E., Jean‐Louis, G., & Seixas, A. A. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00308-x
Self-citationEllis, J. G., & Alfonso‐Miller, P. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00113-4
Self-citationMartin‐Willett, R., Master, A., Bidwell, L. C., & Sznitman, S. R. (2022) · Springer eBooks · doi:10.1007/978-3-030-92392-1_70
Addressing Impaired Sleep Among Adults in the Psychiatric Care Setting
Kverno, K. S. (2023) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20230818-02
Oasi, C., Mohamed, B., & Belmin, J. (2023) · Elsevier eBooks · doi:10.1016/b978-2-294-77815-5.00066-4
Chronic insomnia and ways to overcome it
Мищенко, Т. С., Забродіна, Л. П., Mishchenko, V. М., & Bovt, Y. V. (2024) · Psychiatry Neurology and Medical Psychology · doi:10.26565/2312-5675-2024-23-03
The State of Sleep: Understanding Insomnia Symptoms and Treatments in US AdultsPreprint
Fisher, M., Perlis, M. L., Krystal, A. D., & Heffler, M. J. (2025) · medRxiv · doi:10.1101/2025.08.21.25333428
Self-citationKim, D., Yoo, H., Oh, H., Kim, S., Choi, G., & Cho, S. H. (2025) · Food Bioscience · doi:10.1016/j.fbio.2025.107596
Sleep disturbance symptoms and treatment patterns in US adults: findings from a national survey
Fisher, M., Perlis, M. L., Krystal, A. D., & Heffler, M. J. (2026) · Sleep Science and Practice · doi:10.1186/s41606-026-00192-9
Self-citationRichdale, A. L., Maria, F. R. D., & Morris, E. M. J. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70072
Wang, Q., Gong, Y., Ji, J., Zhang, Y., Lu, M., Song, M., Zhang, X., Zhao, Y. J., & Miao, Q. (2026) · ALPHA PSYCHIATRY · doi:10.31083/ap50350
Ayurveda Treatments for Insomnia: A Narrative Review
Vendrame, M., & Chai, V. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15176750
Zhang, Y., Zhang, H., Tang, J., Wang, Y., & Wu, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1928430
- Authors
- Vargas, I., Nguyen, A. M., Muench, A., Bastien, C. H., Ellis, J. G., & Perlis, M. L.
- Affiliations
- Department of Psychological Science, University of Arkansas, Fayetteville, AR 72701, USA
- University of Arkansas at Fayetteville (US)
- University of Pennsylvania (US)
- Université Laval (CA)
- Northumbria University (GB)
- Venue
- Brain Sciences
- Publisher
- MDPI AG
- Published
- 2020-01-29
- Volume
- 10
- Issue
- 2
- Pages
- 71
- ISSN
- 2076-3425 (ISSN-L)
- PMC
- PMC7071368
- OpenAlex
- W3003440523
- Cited by
- 58
- References
- 95
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 10 · 2023: 11 · 2022: 10 · 2021: 9 · 2020: 2
- FWCI
- 7.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Brain Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Northumbria Research Link (Northumbria University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health
- National Institute on Aging (K24AG055602)
- National Heart, Lung, and Blood Institute (T32HL007713, K23HL141581)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- acute insomnia, chronic insomnia, hyperarousal, insomnia pathophysiology, sleep initiation and maintenance
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