ReviewNature and science of sleep2018
Hyperarousal and sleep reactivity in insomnia: current insights.
Review in Nature and science of sleep, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 151 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
151 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mind-body therapies for sleep disturbances, depression, and anxiety in menopausal women: a systematic review and meta-analysis of randomized controlled trials.Frontiers in public health · 2025Pooled it
- Sleep Problems and Workplace Violence: A Systematic Review and Meta-Analysis.Frontiers in neuroscience · 2019Pooled it
- Cognitive behavioral therapy for insomnia is associated with reduced sleep apnea severity but not its endotype traits in those with comorbid insomnia and sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Trial
- Acupuncture modulates emotional network resting-state functional connectivity in patients with insomnia disorder: a randomized controlled trial and fMRI study.BMC complementary medicine and therapies · 2024Trial
- Trial
- Hyperarousal and Insomnia in Survivors of Cancer.International journal of behavioral medicine · 2021Trial
- Open-loop Audio-Visual Stimulation for sleep promotion in older adults with comorbid insomnia and osteoarthritis pain: results of a pilot randomized controlled trial.Sleep medicine · 2021Trial
- Trial
- The Sentinel Sleep Theory: Unweaving the biological function of REM sleep.Sleep medicine: X · 2026Article
- Sleep quality is associated with default mode and salience network connectivity differently across age and sex.Neurobiology of aging · 2026Article
- Article
- Sources of Stress in Relation to Sleep Health During the COVID-19 Pandemic: Findings from the National Couples' Health and Time Study.Journal of racial and ethnic health disparities · 2026Article
- The Interplay Between Emotion Dysregulation and Repetitive Thoughts in Insomnia Disorder: The Impact of Worry, Rumination and REM Sleep Instability.Journal of sleep research · 2026Article
- Lower breathing frequencies in personalized slow-paced breathing enhance relaxation and reduce arousal.iScience · 2026Article
- Sleep Duration and Mortality in Women: Effect of Aging and Menopause.Sleep medicine clinics · 2026Review
- Childhood paternal abuse and low paternal affection predict adult panic symptoms 18 years later via actigraphy-indexed sleep disruptions.Psychological medicine · 2026Article
- Sleep hygiene mediates anxiety and sleep quality in adults: mediation and network analysis.BJPsych open · 2026Article
- Trauma appraisals in the first month after sexual trauma differentially predict subsequent mental and physical health sequelae.Psychological trauma : theory, research, practice and policy · 2026Article
- Examining Sleep-Related Problems in Youth With Misophonia.Journal of clinical psychology · 2026Article
- Skin-deep resilience in Black youth: Striving and sleep reactivity to daily stress.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026Article
91 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.