Sleep medicine reviewsJul 8, 2008

How Insomnia Is Linked to Changes in Body Temperature

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 31, 2026

Abstract

Different types of insomnia symptoms are associated with abnormalities in the body's temperature rhythm.

Sleep is most conducive when core body temperature is at its lowest.
Sleep onset insomnia may occur during a delayed evening wake maintenance zone due to a delayed temperature rhythm.
Morning bright light treatment has been effective in phasing advance circadian rhythms for sleep onset insomnia.
Early morning awakening insomnia is linked to a phase advanced temperature rhythm and can be treated with evening bright light.
Sleep maintenance insomnia is associated with elevated core body temperature rather than circadian rhythm timing issues.
A combination of sleep onset and maintenance insomnia correlates with a sustained 24-hour elevation of core body temperature.

Simplified

Sleepiness and sleep propensity are strongly influenced by our circadian clock as indicated by many circadian rhythms, most commonly by that of core body temperature. Sleep is most conducive in the temperature minimum phase, but is inhibited in a "wake maintenance zone" before the minimum phase, and is disrupted in a zone following that phase. Different types of insomnia symptoms have been associated with abnormalities of the body temperature rhythm. Sleep onset insomnia is associated with a delayed temperature rhythm presumably, at least partly, because sleep is attempted during a delayed evening wake maintenance zone. Morning bright light has been used to phase advance circadian rhythms and successfully treat sleep onset insomnia. Conversely, early morning awakening insomnia has been associated with a phase advanced temperature rhythm and has been successfully treated with the phase delaying effects of evening bright light. Sleep maintenance insomnia has been associated not with a circadian rhythm timing abnormality, but with nocturnally elevated core body temperature. Combination of sleep onset and maintenance insomnia has been associated with a 24-h elevation of core body temperature supporting the chronic hyper-arousal model of insomnia. The possibility that these last two types of insomnia may be related to impaired thermoregulation, particularly a reduced ability to dissipate body heat from distal skin areas, has not been consistently supported in laboratory studies. Further studies of thermoregulation are needed in the typical home environment in which the insomnia is most evident.

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How Insomnia Is Linked to Changes in Body Temperature

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