# You Are at Risk of Insomnia When You Do Not Accept Your Pre-Sleep Arousal: A Cross-Sectional Study Investigating the Relationship Between Mindfulness, Pre-Sleep Arousal and Severity of Insomnia Symptoms

## TL;DR

This study shows that accepting pre-sleep arousal, a key part of mindfulness, can reduce insomnia symptoms by lowering arousal levels before sleep.

## Contribution

The study identifies acceptance as a novel mechanism through which mindfulness reduces insomnia symptoms.

## Key findings

- Acceptance, but not awareness, was negatively linked to insomnia severity and pre-sleep arousal.
- Acceptance reduces insomnia symptoms both directly and indirectly by lowering cognitive and somatic arousal.
- The study highlights acceptance as a key mindfulness trait for improving sleep.

## Abstract

Background/Objectives: Psychophysiological insomnia is characterized by acquired sleep difficulties and/or a state of hyperarousal when falling asleep. This hyperarousal can develop and/or maintain insomnia. In contrast, mindfulness can reduce stress and improve sleep. This cross-sectional study aimed to assess the relationship between mindfulness traits (acceptance and awareness), pre-sleep arousal (cognitive and somatic) states, and insomnia symptoms. Methods: A sample of 464 non-clinical volunteers (352 females; mean age 27.89 ± 9.48 years) participated in this online cross-sectional study, completing the Philadelphia Mindfulness Scale (PHLMS), Pre-Sleep Arousal State (PSAS), and Insomnia Severity Index (ISI). Results: The acceptance component of mindfulness but not awareness negatively correlated with ISI, as well as PSAS subscales. In a mediation model, acceptance was associated with ISI both directly and indirectly, through associations with cognitive arousal and somatic arousal. Conclusions: This study suggests a possible mechanism by which mindfulness works to influence sleep processes. In particular, acceptance can reduce pre-sleep arousal, reducing the possibility of developing and/or maintaining insomnia symptoms.