The pathophysiology of insomnia remains poorly understood, yet emerging cross-disciplinary approaches integrating natural history, observational studies in traditional populations, gene-phenotype expression and experiments are opening up new avenues to investigate the evolutionary origins of sleep disorders, with the potential to inform innovations in treatment. Previous authors have supported that acute insomnia is a normal biopsychosocial response to a perceived or real threat and may thus represent an adaptive response to stress. We further extend this hypothesis by claiming that insomnia reflects a fear-related evolutionary survival mechanism, which becomes persistent in some vulnerable individuals due to failure of the fear extinction function. Possible treatments targeting fear extinction are proposed, such as pharmacotherapy and emotion-based cognitive behavioral therapy.

失眠的病理生理学仍知之甚少，但新兴的跨学科方法结合了自然史，传统人群的观察性研究，基因表型表达和实验，为探索睡眠障碍的进化起源开辟了新途径，并有可能为创新提供信息治疗中。先前的作者支持说，急性失眠是对感知到的或真实威胁的正常生物心理反应，因此可能代表对压力的适应性反应。我们通过声称失眠反映了一种与恐惧有关的进化生存机制，进一步扩展了这一假设，由于恐惧消除功能的失败，这种机制在某些脆弱的个体中变得持久。提出了针对恐惧消除的可能疗法，