Hyperarousal and insomnia in survivors of cancer Journal Article


Authors: Riley, K. E.; Garland, S. N.; Mao, J. J.; Applebaum, A. J.; Li, Q. S.; Gehrman, P. R.; DuHamel, K. N.; Verrico, Z.
Article Title: Hyperarousal and insomnia in survivors of cancer
Abstract: Background: Cancer survivors are prone to insomnia due to the physical and psychological sequelae of cancer and treatment. Individuals with insomnia may present symptoms of hyperarousal. Cancer survivors with insomnia and trait hyperarousal may require different clinical treatments than patients with insomnia without trait hyperarousal. To our knowledge, no study has examined these factors previously. This study examined the relation between insomnia and trait hyperarousal in cancer survivors. Methods: The sample included 160 individuals with previous cancer diagnoses who met DSM-5 criteria for insomnia disorder. Measures were collected with cross-sectional batteries of questionnaires, including the Insomnia Severity Index (ISI) and Hyperarousal Scale (HAS). This study is based on baseline data collected in a randomized clinical trial comparing CBT-I to acupuncture for cancer survivors with insomnia (Garland, Gehrman, Barg, Xie, & Mao, 2016). Results: Hyperarousal was positively associated with insomnia (ISI total score) in bivariate correlations (r =.350, p <.01) and linear regressions (F = 22.06, p <.001). In bivariate correlations, hyperarousal was related to perceptions about the consequences of disturbed sleep rather than reported sleep patterns. For example, hyperarousal was positively related to reported satisfaction (r =.159, p <.05) and worry about sleep (r =.415, p <.01), but not to falling asleep, staying asleep, or awakening too early. In regressions, younger age, insomnia duration, and worry about sleep were uniquely associated with hyperarousal when adjusting for insomnia (B = 0.200, B = 0.177, B = −0.182, p <.05). Conclusions: Hyperarousal is associated with psychological appraisal of insomnia rather than reported sleep pattern. Younger age and longer duration of insomnia are associated with trait hyperarousal. These findings suggest targeting trait hyperarousal with amplified psychological treatment may lead to more personalized, effective treatment for insomnia. © 2021, International Society of Behavioral Medicine.
Keywords: insomnia; sleep; cancer; hyperarousal
Journal Title: International Journal of Behavioral Medicine
Volume: 28
Issue: 6
ISSN: 1070-5503
Publisher: Springer  
Date Published: 2021-12-01
Start Page: 683
End Page: 691
Language: English
DOI: 10.1007/s12529-021-09962-4
PROVIDER: scopus
PMCID: PMC8438992
PUBMED: 33629219
DOI/URL:
Notes: Article -- Export Date: 1 December 2021 -- Source: Scopus
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MSK Authors
  1. Katherine N Duhamel
    99 Duhamel
  2. Allison Joyce Applebaum
    191 Applebaum
  3. Jun J Mao
    244 Mao
  4. Kristen E Riley
    15 Riley
  5. Qing Susan Li
    82 Li