Hyperarousal insomnia: Definition, Symptoms, and Treatment

Andreas Meistad profile picture
Andreas Meistad
Aug 23, 20213 min read
Alert bunny in the wild

A delicate balance between two opposing systems governs our body and mind at any given time. The sympathetic system is the body’s threat detection system that prepares your body to respond to any threat. On the other hand, the parasympathetic system calms the body and mind and induces a state of relaxation.

'Everything in life has to have balance.' - Donna Karan.

When the balance tilts in favor of the sympathetic system, hyperarousal ensues. A heightened threat detection system, though, comes at a cost.

Read on to learn what hyperarousal is, its symptoms and causes, how it affects your sleep, and what you can do about it.

What is Hyperarousal?

Hyperarousal is defined as a state where you are more alert or vigilant. Usually, alertness is caused by the brain detecting a threat and entering fight-or-flight mode. The cause can be a real external threat or internal; for example, worrying about the consequences of not getting enough sleep. It is completely normal and something that we all experience from time to time.

The level of hyperarousal one can experience varies a lot, the most extreme being Post-Traumatic Stress Disorder (PTSD). Note that PTSD is not a normal state, and you do not have to have PTSD to experience hyperarousal. It can manifest itself as a subtle sense of unease that you might not even become aware of, but can still disrupt your sleep.

Hyperarousal is also used to describe other states where you feel emotions like curiosity, bewilderment, frustration, or anger.

The stimuli can be external, internal, physical or emotional, since your body cannot differentiate between the two. This leads to symptoms such as:

  • Difficulty falling or staying asleep
  • Vivid dreams about a traumatic event
  • Mood disturbances
  • Constant anxiety and worry
  • Easily unsettled or startled
  • Self-condemnation and guilt

Hyperarousal Insomnia

Sleep requires the body and mind to relax. It is predominantly a parasympathetic activity. But, in a hyperaroused state, the sympathetic system overpowers the parasympathetic one. This leads to hyperarousal insomnia. This makes evolutionary sense because sleeping when there is an imminent threat significantly lowers your chances of survival.

Being constantly on high alert can cause sleep to be delayed and rapid, anxious thoughts to occur at night. Further, inadequate sleep can then lead to more stress. Put differently; it is a self-propagating cycle.

Unfortunately, if stress is keeping you up at night, you are not alone. According to the National Sleep Foundation Survey, 43% of adults have trouble sleeping due to stress every month. Even though you may have been struggling to sleep, you do not have to. Practical, simple treatments for hyperarousal insomnia exist.

Hyperarousal Insomnia Treatment

Hyperarousal insomnia is a psychological condition. In other words, it is a mental state that triggers the body to react physically and mentally to thoughts and emotions. Fortunately, this mental state can be reversed.

Cognitive-behavioral therapy for insomnia (CBT-I) directly addresses both our thoughts and behaviors. It is a type of talking therapy that focuses on the idea that how we think, our habits, and our emotions are all linked and influence one another. We can ease mental suffering by challenging our thoughts, changing our habits, and accepting our feelings. CBT-I allows us to do that and more.

Learn more about CBT-I

To get more information about hyperarousal insomnia and use Dawn’s evidence-based CBT-I to treat your hyperarousal insomnia, contact us today!


Andreas Meistad profile picture
Andreas Meistad

Therapist specializing in applying CBT principles for the treatment of insomnia.

It’s time to stop blaming the night monsters.
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