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British Journal of Medical and Health Research

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Examining Physiological Hyperarousal in the Relationship Between Insomnia and Nightmare Proneness

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Published in September 2026 Issue 09 (Vol. 13, Issue 9, 2026)

Examining Physiological Hyperarousal in the Relationship Between Insomnia and Nightmare Proneness - Issue cover

Keywords

Nightmare pronenessInsomniaHyperarousalNightmaresSleepNeuroticism

Abstract

Background: Nightmare proneness has been associated with insomnia beyond nightmare frequency and neuroticism. The present study examined physiological hyperarousal as a potential process contributing to this relationship. Methods: Participants were 209 adults recruited from a university participant pool and an online community sample. Participants completed self-report measures of nightmare proneness, insomnia, physiological hyperarousal, nightmare frequency, neuroticism, and trauma symptoms. Hierarchical regression and indirect-effect analyses were conducted. Results: After controlling for recruitment source, gender, nightmare frequency, neuroticism, and trauma symptoms, nightmare proneness explained an additional 6.5% of the variance in insomnia. Physiological hyperarousal accounted for an additional significant 2.2% of variance beyond nightmare proneness. Nightmare proneness showed a significant indirect association with insomnia through physiological hyperarousal. However, nightmare proneness maintained an direct association with insomnia outside physiological hyperarousal. Conclusion: Physiological hyperarousal may represent one process contributing to the relationship between nightmare proneness and insomnia but does not fully account for this association. The findings support conceptualizing nightmare proneness and physiological hyperarousal as related but non-redundant factors associated with insomnia.

References

  1. [1]1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed., text rev. American Psychiatric Association; 2022.
  2. [2]2. Dressle RJ, Riemann D. Hyperarousal in insomnia disorder: current evidence and potential mechanisms. J Sleep Res. 2023;32(6):e13928. doi: 10.1111/jsr.13928.
  3. [3]3. Kelly WE. What are the building blocks of nightmare proneness? Examining potential etiological factors. Imagin Cogn Pers. 2025;44(3):287-314. doi: 10.1177/02762366241302706.
  4. [4]4. Toscano-Hermoso MD, Arbinaga F, Fernández-Ozcorta EJ, Gómez-Salgado J, Ruiz-Frutos C. Influence of sleeping patterns in health and academic performance among university students. Int J Environ Res Public Health. 2020;17(8):2760. doi: 10.3390/ijerph17082760.
  5. [5]5. Kelly WE. Bad dreams and bad sleep: relationships between nightmare frequency, insomnia, and nightmare proneness. Dreaming. 2022;32(2):194-205. doi: 10.1037/drm0000203.
  6. [6]6. Coren S, Mah KB. Prediction of physiological arousability: a validation of the Arousal Predisposition Scale. Behav Res Ther. 1993;31(2):215-219. doi: 10.1016/0005-7967(93)90076-7
  7. [7]7. Blaskovich B, Reicher V, Gombos F, Spoormaker VI, Simor P. Hyperarousal captured in increased number of arousal events during pre-REM periods in individuals with frequent nightmares. J Sleep Res. 2020;29(5):e12965. doi: 10.1111/jsr.12965.
  8. [8]8. Kelly WE. Autonomic hyperarousal and chronotype as psychobiological correlates of nightmare-relevant dispositions. Individ Differ Res. 2024;22:e22006. doi: 10.65030/idr.22006.
  9. [9]9. Dai Y, Ma J, Vgontzas AN, Chen B, Chen L, Wu J, et al. Insomnia disorder is associated with 24-hour cortical hyperarousal. Sleep Med. 2024;124:681-687. doi: 10.1016/j.sleep.2024.11.002.
  10. [10]10. Walker JL, Vargas I, Drake CL, Ellis JG, Muench A, Perlis ML. The natural history of insomnia: high sleep reactivity interacts with greater life stress to predict the onset of acute insomnia. Sleep. 2022;45(9):zsac149. doi: 10.1093/sleep/zsac149.
  11. [11]11. Cellini N, Duggan KA, Sarlo M. Perceived sleep quality: the interplay of neuroticism, affect, and hyperarousal. Sleep Health. 2017;3(3):184-189. doi: 10.1016/j.sleh.2017.03.001.
  12. [12]12. Delage JP, Côté J, Journault WG, Lemyre A, Bastien CH. The relationships between insomnia, nightmares, and dreams: a systematic review. Sleep Med Rev. 2024;75:101931. doi: 10.1016/j.smrv.2024.101931.
  13. [13]13. Gieselmann A, Ait Aoudia M, Carr M, et al. Aetiology and treatment of nightmare disorder: state of the art and future perspectives. J Sleep Res. 2019;28(4):e12820. doi: 10.1111/jsr.12820.
  14. [14]14. Reffi AN, Kalmbach DA, Cheng P, et al. Nightmares and insomnia within the acute aftermath of trauma prospectively predict suicidal ideation. J Clin Sleep Med. 2025;21(9):1519-1527. doi: 10.5664/jcsm.11744.
  15. [15]15. Kelly WE. Validity, reliability, and incremental prediction of nightmares using a shortened form of the Nightmare Proneness Scale (NPS-6). Individ Differ Res. 2026;24(1):e24003. doi: 10.65030/idr.24003.
  16. [16]16. Joiner TE Jr, Steer RA, Beck AT, Schmidt NB, Rudd MD, Catanzaro SJ. Physiological hyperarousal: construct validity of a central aspect of the tripartite model of depression and anxiety. J Abnorm Psychol. 1999;108(2):290-298. doi: 10.1037/0021-843X.108.2.290.
  17. [17]17. Körner A, Geyer M, Roth M, Drapeau M, Schmutzer G, Albani C, et al. Persönlichkeitsdiagnostik mit dem NEO-Fünf-Faktoren-Inventar: die 30-Item-Kurzversion (NEO-FFI-30). Psychother Psychosom Med Psychol. 2008;58(6):238-245. doi: 10.1055/s-2007-986199.
  18. [18]18. Prins A, Ouimette P, Kimerling R, et al. The Primary Care PTSD Screen (PC-PTSD): development and operating characteristics. Prim Care Psychiatry. 2004;9:9-14. doi: 10.1185/135525703125002360.
  19. [19]19. Kelly WE. The Nightmare Frequency Index-3: reliability and validity of a brief measure of nightmares. J Int Scholarsh. 2026;1(1):e011004. doi: 10.65030/jis.011004.
  20. [20]20. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. 3rd ed. New York: Guilford Press; 2022.
  21. [21]21. Paul F, Alpers GW, Reinhard I, Schredl M. Nightmares do result in psychophysiological arousal: a multimeasure ambulatory assessment study. Psychophysiology. 2019;56(7):e13366. doi: 10.1111/psyp.13366.

Authors (3)

William E. Kelly

University of the Incarnate Wo...

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Ani Enriquez

University of the Incarnate Wo...

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Faith Yanez

University of the Incarnate Wo...

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Article Information

Published in:

September 2026 Issue 09 (Vol. 13, Issue 9, 2026)

BJMHR9130006

BJMHR-13-000062

53-62

2026-09-21

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How to Cite

Kelly, W. E., Enriquez, A., & Yanez, F. (2026). Examining Physiological Hyperarousal in the Relationship Between Insomnia and Nightmare Proneness. British Journal of Medical and Health Research, 13(9), 53-62. https://bjmhr.com/articles/BJMHR9130006

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