Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA.
Department of Psychology, University of Virginia, Charlottesville, Virginia, USA.
Sleep Health. 2023 Apr;9(2):218-227. doi: 10.1016/j.sleh.2023.01.011. Epub 2023 Feb 10.
The evening ("night owl") chronotype is associated with greater severity and lifetime prevalence of post-traumatic stress disorder (PTSD) symptoms compared to morning or intermediate chronotypes. This twin study investigated the gene-environment relationships between chronotype, recent PTSD symptoms, and lifetime intrusive symptoms.
We used the reduced Horne-Östberg Morningness-Eveningness Questionnaire (rMEQ) to assess chronotype in a sample of 3777 same-sex adult twin pairs raised together (70.4% monozygotic, 29.6% dizygotic) in the community-based Washington State Twin Registry. PTSD symptoms were reported on the Impact of Events Scale (IES) and a single item for lifetime experience of intrusive symptoms after a stressful or traumatic event.
Genetic influences accounted for 50% of chronotype variance, 30% of IES score variance, and 14% of lifetime intrusive symptom variance. Bivariate twin models showed a phenotypic association (b) between evening chronotype and more severe PTSD symptoms (b = -0.16, SE = 0.02, p < .001) that remained significant even after adjusting for shared genetic and environmental influences (b = -0.10, SE = 0.04, p = .009), as well as age, sex, and self-reported sleep duration (b = -0.11, SE = 0.04, p = .004). An association was found between evening chronotype and lifetime intrusive symptoms (b = -0.11, SE = 0.03, p < .001) that was no longer significant after adjusting for shared genetic and environmental influences (b = 0.04, SE = 0.06, p = .558).
Our results suggest a "quasi-causal" relationship between evening chronotype and PTSD symptoms that is not purely attributable to genetic or shared environmental factors. Evening chronotype may increase vulnerability to pathologic stress responses in the setting of circadian misalignment, providing potential avenues of prevention and treatment using chronobiological strategies.
与早晨或中间型相比，夜间（“夜猫子”）时型与创伤后应激障碍（PTSD）症状的严重程度和终生患病率更高。本双胞胎研究调查了时型、近期 PTSD 症状和终生闯入症状之间的基因-环境关系。
我们使用简化的霍恩-奥斯特伯格清晨-黄昏时型问卷（rMEQ）在社区为基础的华盛顿州双胞胎登记处的 3777 对共同抚养的同性别成年双胞胎样本（70.4%同卵双胞胎，29.6%异卵双胞胎）中评估时型。创伤后应激障碍症状报告采用事件影响量表（IES）和单一项目进行，该项目用于报告在压力或创伤事件后经历闯入症状的终生经历。
遗传因素占时型变异的 50%、IES 评分变异的 30%和终生闯入症状变异的 14%。双变量双胞胎模型显示，夜间时型与更严重的 PTSD 症状之间存在表型关联（b=-0.16，SE=0.02，p<0.001），即使在调整了共享遗传和环境影响（b=-0.10，SE=0.04，p=0.009）、年龄、性别和自我报告的睡眠时间（b=-0.11，SE=0.04，p=0.004）后，这种关联仍然显著。还发现夜间时型与终生闯入症状之间存在关联（b=-0.11，SE=0.03，p<0.001），但在调整了共享遗传和环境影响后，这种关联不再显著（b=0.04，SE=0.06，p=0.558）。
我们的研究结果表明，夜间时型与 PTSD 症状之间存在“准因果”关系，这种关系不能纯粹归因于遗传或共享的环境因素。夜间时型可能会增加在昼夜节律失调情况下病理性应激反应的易感性，为使用生物钟策略进行预防和治疗提供了潜在途径。
