Hyperarousal and Beyond: New Insights to the Pathophysiology of Insomnia Disorder through Functional Neuroimaging Studies

• Main Authors: Daniel B. Kay, Daniel J. Buysse
• Format: Article
• Language: English
• Published: MDPI AG 2017-02-01
• Series: Brain Sciences
• Subjects: insomnia; neuroimaging; heuristic model; hyperarousal
• Online Access: http://www.mdpi.com/2076-3425/7/3/23

Neuroimaging studies have produced seemingly contradictory findings in regards to the pathophysiology of insomnia. Although most study results are interpreted from the perspective of a “hyperarousal” model, the aggregate findings from neuroimaging studies suggest a more complex model is needed. We provide a review of the major findings from neuroimaging studies, then discuss them in relation to a heuristic model of sleep-wake states that involves three major factors: wake drive, sleep drive, and level of conscious awareness. We propose that insomnia involves dysregulation in these factors, resulting in subtle dysregulation of sleep-wake states throughout the 24 h light/dark cycle.