Can’t Sleep? Blame it On Your Genes!

31 Aug 2020

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Most of us experience either acute or chronic insomnia at some point in our lives. However, we tend to overlook this issue until it becomes severe. This is because we believe that it is an unavoidable aspect of our modern, fast-paced lifestyle. However, insomnia can have a serious impact on our overall health as it increases the risk of a host of physical and mental ailments including obesity, heart diseases, diabetes, blood pressure, depression and anxiety. In most cases, it is brought on by bad lifestyle choices and poor sleeping habits.  

How Genetics Affects Insomnia 

Insomnia has long been associated with irregular sleep-wake schedules, poor lifestyle choices and high levels of stress. However, in the last few decades, scientists started to suspect that insomnia could have a genetic component but the scale of their research was limited. Their suspicions were confirmed when a genome-wide analysis [1] of insomnia in 1,331,010 individuals found that insomnia has a partially heritable basis. This study implicated 956 genes in 202 areas of the genome which are linked to insomnia. Interestingly, there was also significant overlap between the genes implicated in insomnia and those for depression, anxiety, schizophrenia, coronary artery disease and type-2 diabetes which suggests that insomnia is strongly related to these disorders. 

Management Options For Hereditary Insomnia 

Genetic research into insomnia is still in its early stages and it will take at least two decades for these discoveries to make their way into clinical practice, especially therapies. Currently, a hereditary insomnia disposition doesn’t require any drastic change in treatment methods. The treatment method for insomnia differs from one patient to the next as it depends on a variety of factors, including the severity of the condition and their overall health status. Patients are first evaluated to rule out medical and psychological causes for their insomnia. As a general rule of thumb, the first line of treatment for insomnia is a combination of lifestyle changes and cognitive behavioral therapy (CBT). 

Lifestyle Changes 

Lifestyle changes include following regular sleep and waking times and avoiding large meals, caffeine and alcohol before bedtime. Regular physical exercise also plays an important role as it reduces anxiety and depressive symptoms and helps to increase sleep quality and quantity. Make sure that you limit your workouts to the daytime as vigorous exercise just before bedtime can aggravate your insomnia. Studies [2] show that exposure to blue-wavelength light from electronic devices before bedtime can exacerbate insomnia so put away your phone and switch off your TV at least one hour before you go to bed. You can listen to soothing music or spend some time in meditation to relax your mind and body and prepare you for sleep. 

Cognitive Behavioral Therapy

Cognitive behavioral therapy for insomnia helps to identify behaviors and thoughts that cause or aggravate sleep problems. Once these are identified, they can be replaced by habits that promote sound sleep. For instance, if you suffer from insomnia, lying in bed even though you’re awake becomes a habit which results in poor sleep. The CBT technique of sleep restriction [3] reduces the time you spend in your bed. This leads to mild sleep deprivation which makes you tired the next night – this will increase the likelihood of you falling asleep quickly. This effectively eliminates your habit of lying awake in bed and once your sleep improves, you can go back to your regular sleep timings. 

Insomnia is a curable condition. Medications such as sleeping pills and sedatives may be used to reduce insomnia symptoms when the duration is short but doctors do not recommend the long-term use of these prescription medications due to their side effects. According to sleep experts, almost all cases can be resolved with work and commitment on the part of the individual.  

References:

  1. Jansen, Philip R et al. “Genome-wide analysis of insomnia in 1,331,010 individuals identifies new risk loci and functional pathways.” Nature genetics vol. 51,3 (2019): 394-403. doi:10.1038/s41588-018-0333-3
  2. Shechter, Ari et al. “Blocking nocturnal blue light for insomnia: A randomized controlled trial.” Journal of psychiatric research vol. 96 (2018): 196-202. doi:10.1016/j.jpsychires.2017.10.015
  3. “Understanding CBT-I: Limiting Your Time in Bed.” US Department of Veterans Affairs, www.veteranshealthlibrary.va.gov/LivingWith/Insomnia/Treatment/142,41436_VA

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