• Julio Fernández-Mendoza, Antonio Vela-Bueno, Alexandros N Vgontzas, María José Ramos-Platón, Sara Olavarrieta-Bernardino, Edward O Bixler, and Juan José De la Cruz-Troca.
• Departments of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
• Psychosom Med. 2010 May 1; 72 (4): 397-403.

ObjectiveTo examine whether cognitive-emotional hyperarousal is a premorbid characteristic of middle-aged and young good sleepers vulnerable to stress-related insomnia.MethodsSelf-reported information was collected from two samples of 305 middle-aged and 196 young adults. From those adults, 149 middle-aged (50.34 +/- 4.47 years) and 85 young (20.19 +/- 1.31 years) good sleepers were selected for the present study. The Ford Insomnia Response to Stress Test (FIRST) was used to measure vulnerability to stress-related insomnia. Trait measures of personality, arousability, rumination, presleep arousal, and coping skills were entered as predictors in the linear regression models, at the same time controlling for gender, depression, and anxiety.ResultsThe regression models showed that arousability (beta = 0.546), neuroticism (beta = 0.413), perceived stress (beta = 0.375), and rumination (beta = 0.214) were associated with FIRST scores in middle-aged adults. Among young adults, the regression models revealed that presleep cognitive arousal (beta = 0.448), arousability (beta = 0.426), neuroticism (beta = 0.320), presleep somatic arousal (beta = 0.290), emotion-oriented coping (beta = 0.220), and rumination (beta = 0.212) were associated with FIRST scores. Finally, individuals with high FIRST scores did not show lower scores in measures of cognitive-emotional hyperarousal compared with chronic insomniacs.ConclusionsThese data suggest that cognitive-emotional hyperarousal may be a premorbid characteristic of subjects vulnerable to insomnia. It seems that maladaptive coping stress strategies and cognitive-emotional hyperarousal predispose to the development of insomnia and that interventions targeting these characteristics may be important in the prevention and treatment of chronic insomnia.

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