Predisposition in the Evolution of Insomnia: Evidence, Potential Mechanisms, and Future Directions

Hyperarousal is accepted as a major component of insomnia, but its role in defining the pathophysiology of insomnia is not well understood. In fact, hyperarousal as the factor that predisposes individuals to acute/transient sleep disturbance and its subsequent contribution to the development of chronic insomnia have rarely been investigated. This article presents the hypothesis and supporting data that elevated sleep reactivity to stress is a trait characteristic and an important premorbid risk factor for the later development of chronic insomnia.