Research
Hormonal
Primary insomnia is characterized by a state of hyperarousal across cognitive, physiological, and behavioral domains, including elevated HPA axis activity, autonomic dominance, and increased cortical EEG beta activity.
Insomnia is not just 'bad luck' or 'sensitivity to noise'; it is a physiological state of hyperarousal involving your stress hormones, brain activity, and heart rate. Effective treatment must address this internal arousal state, not just the environment.
GoodSupportsHIGH confidence
Converging evidence from cognitive, endocrine, neurological, and behavioral domains provide clear evidence for hyperarousal in insomnia.
Why this rating
Supported by multiple physiological measures (cortisol, EEG, heart rate variability) across several studies.
Source
Insomnia causes, consequences, and therapeutics: An overview
Christopher L. Drake et al. · Depression and Anxiety · 2003
DOI 10.1002/da.10151
narrative_reviewCited 307×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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- Insomnia is associated with a substantial and statistically significant increased risk for the subsequent development of major depressive disorder, with insomnia often predating the onset of depression.Good
- Insomnia imposes a massive economic burden on society, estimated at over $77 billion per year in the US, driven by lost productivity, accidents, and absenteeism.Moderate
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