Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy.
Département de Psychiatrie et D'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France.
J Sleep Res. 2023 Dec;32(6):e13868. doi: 10.1111/jsr.13868. Epub 2023 Mar 14.
Insomnia is a stress-related sleep disorder conceptualised within a diathesis-stress framework, which it is thought to result from predisposing factors interacting with precipitating stressful events that trigger the development of insomnia. Among predisposing factors genetics and epigenetics may play a role. A systematic review of the current evidence for the genetic and epigenetic basis of insomnia was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system. A total of 24 studies were collected for twins and family heritability, 55 for genome-wide association studies, 26 about candidate genes for insomnia, and eight for epigenetics. Data showed that insomnia is a complex polygenic stress-related disorder, and it is likely to be caused by a synergy of genetic and environmental factors, with stress-related sleep reactivity being the important trait. Even if few studies have been conducted to date on insomnia, epigenetics may be the framework to understand long-lasting consequences of the interaction between genetic and environmental factors and effects of stress on the brain in insomnia. Interestingly, polygenic risk for insomnia has been causally linked to different mental and medical disorders. Probably, by treating insomnia it would be possible to intervene on the effect of stress on the brain and prevent some medical and mental conditions.
失眠是一种与压力相关的睡眠障碍，被认为是在素质-应激框架内产生的，它是由易患因素与引发失眠的诱发压力事件相互作用引起的。在易患因素中，遗传和表观遗传可能起作用。根据系统评价和荟萃分析的首选报告项目（PRISMA）系统，对失眠的遗传和表观遗传基础的现有证据进行了系统评价。共收集了 24 项关于双胞胎和家族遗传性的研究、55 项全基因组关联研究、26 项关于失眠候选基因的研究和 8 项关于表观遗传学的研究。研究表明，失眠是一种复杂的多基因应激相关障碍，很可能是由遗传和环境因素的协同作用引起的，与应激相关的睡眠反应是重要特征。尽管迄今为止对失眠症的研究很少，但表观遗传学可能是理解遗传和环境因素相互作用以及压力对失眠症大脑影响的长期后果的框架。有趣的是，失眠的多基因风险与不同的精神和医学障碍有关。可能通过治疗失眠，可以干预压力对大脑的影响，预防一些医学和精神疾病。
