Pre-sleep cognitive arousal is a key factor in maintaining insomnia. Intrusive thoughts such as rumination and worry are the main forms of pre-sleep cognitive arousal， which are generated and maintained by the interaction of metacognition， sleep beliefs， stress and strain and further influence insomnia. Classical cognitive-behavioral therapy for insomnia and relaxation training have limited effect on pre-sleep cognitive arousal， based on which augmentation programs incorporating mindfulness have more advantages in reducing pre-sleep cognitive arousal. This study reviews the factors influencing pre-sleep cognitive arousal and intervention programs based on the relationship between insomnia and pre-sleep cognitive arousal.