Overnight Vulnerable Emotion Reset Normalizing Invalidating Generalized Hyperaroused Tension

Anxiety and insomnia account for one-third of the global mental health burden. Prognosis is poor: chronicity and relapse are common because treatment effectiveness is moderate. While this situation calls for treatment innovation, the required knowledge on targetable key mechanisms is lacking.

Their shared core symptom is hyperarousal, covering subjective, physiological and clinical indicators. Hyperarousal is not 'just another overlapping symptom': individual differences in hyperarousal determine severity, prognosis and treatment response across insomnia-, anxiety- and stress-disorders. Hyperarousal links their genetic and phenotypic overlap.

Since hyperarousal plays such a pivotal role in the development and chronicity of these disorders, a transdiagnostic mechanistic understanding of hyperarousal would have major implications for the direly needed development of better treatment. This project aims for a transdiagnostic mechanistic understanding of hyperarousal across wake and sleep and use to this insight to innovate treatment.

The project will do so by combining large-scale data-driven approaches with targeted testing of the novel hypothesis that hyperarousal may be reset overnight. Crossing disciplines and diagnoses, the project will first deliver an integrated account of the subjective, brain structural, brain functional and physiological hyperarousal landscape. This approach will deliver unprecedented transdiagnostic insights into the lifetime development and underlying brain mechanisms of hyperarousal vulnerability and its consequences for mental health. Moreover, this approach will yield both innovative state-of-the art tools, as well as practical tools, to quantify hyperarousal. These tools will be employed in both experimental preclinical studies and immediately applicable transdiagnostic clinical interventions expected to considerably improve the perspectives of people suffering from the most common mental disorders by alleviating hyperarousal overnight.