In chronic insomnia, the original cause of acute insomnia is often no longer relevant, as the condition takes on a life of its own due to conditioned arousal.

“So acute insomnia, there are an almost unlimited number of things that can cause acute insomnia for a very good reason. I mean, evolution figured out a long time ago that when when we're under periods of stress and our survival is questioned and it's bedtime, we kind of should just keep going until we're safe, right? And we have all these systems in place to protect ourselves. So under any kind of period of of hyperarousal or stress or anything, whether it's mental, physical, or both, we have systems in place that can prolong wakefulness relatively safely, especially in the short term. And so there are a million causes of short-term insomnia, but there's only really one cause of chronic insomnia. And and that's there's a switch that flips from short-term insomnia to chronic insomnia. And that switch is all around the concept of a conditioned arousal.”