Gender and cognitive-emotional factors as predictors of pre-sleep arousal and trait hyperarousal in insomnia

Liisa Hantsoo, Christina S. Khou, Corey N. White, Jason C. Ong

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective: Elevated pre-sleep arousal has been consistently associated with insomnia, yet the cognitive-emotional mechanisms involved in sleep-related arousal remain unclear. The purpose of this study was to identify predictors of pre-sleep arousal and trait hyperarousal from a set of variables that included self-reported affect, sleep-related cognitions, locus of control, and gender. Methods: Cross-sectional data were analyzed for 128 participants (89 females) who met criteria for psychophysiological insomnia and completed a set of questionnaires that included the Beliefs and Attitudes about Sleep (BAS), Positive and Negative Affect Schedule (Negative Subscale (nPANAS) and Positive Subscale (pPANAS)), Sleep Locus of Control (SLOC), Pre-Sleep Arousal Scale (PSAS), Hyperarousal Scale (HAS) and demographic information. Step-wise regression was conducted with a set of independent variables, with PSAS and HAS serving as separate dependent variables. Results: Trait hyperarousal was associated with higher levels of both negative and positive emotionality, as well as negative beliefs about sleep, in both genders. Pre-sleep arousal was associated with greater negative emotionality and internal sleep locus of control, varying by gender. Among women, high pre-sleep arousal was associated with negative emotionality, while in men greater pre-sleep arousal was associated with an internal sleep locus of control. Conclusion: These findings have clinical implications, suggesting that men and women may require different cognitive targets when addressing pre-sleep arousal.

Original languageEnglish (US)
Pages (from-to)283-289
Number of pages7
JournalJournal of Psychosomatic Research
Issue number4
StatePublished - Apr 2013
Externally publishedYes


  • Gender differences
  • Hyperarousal
  • Insomnia
  • Pre-sleep arousal

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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