Central Nervous System Hyperarousal is a state characterized by an abnormally elevated level of neurological alertness and physiological reactivity, often presenting clinically as persistent insomnia, anxiety, or an inability to relax. This condition reflects a chronic imbalance in the autonomic nervous system, where sympathetic (fight-or-flight) activity dominates the parasympathetic (rest-and-digest) tone. Sustained hyperarousal prevents the necessary transition into restorative sleep stages and is a powerful driver of chronic stress, leading to significant dysregulation of the HPA axis and cortisol dynamics.
Origin
This clinical term is rooted in neuroscience and stress physiology, specifically the understanding of the reticular activating system and the neural circuitry governing the sleep-wake cycle. The concept is central to cognitive behavioral therapy for insomnia (CBT-I) and the clinical models of post-traumatic stress. It describes a failure of the homeostatic mechanisms that regulate the transition between wakefulness and sleep.
Mechanism
Hyperarousal is mediated by the sustained release of excitatory neurotransmitters, such as norepinephrine and glutamate, and a failure to adequately suppress evening cortisol levels. This biochemical environment inhibits the consolidation of sleep and prevents the necessary drop in core body temperature required for deep sleep initiation. The resulting sleep deprivation further exacerbates the sympathetic overdrive, creating a self-perpetuating cycle that severely impairs the pulsatile nocturnal release of growth hormone and disrupts the delicate circadian rhythm of sex hormones.
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