Health Conditions
Hyperarousal
A state of elevated physiological and cognitive activation that interferes with sleep onset.
Hyperarousal is a state of heightened physiological and psychological activation that is considered a central feature of chronic insomnia. It manifests as elevated cortisol levels, increased metabolic rate, higher body temperature, faster heart rate, and excessive cognitive activity (racing thoughts) at bedtime. The 3P model of insomnia (Predisposing, Precipitating, Perpetuating) considers hyperarousal a perpetuating factor — the mind becomes conditioned to associate the bed with wakefulness. Hyperarousal can be measured through EEG (increased beta activity during NREM sleep), heart rate variability, and cortisol levels. Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard treatment for hyperarousal-driven insomnia.