Insomnia, sleep quality, pain, and somatic symptoms: Sex differences and shared genetic components

Zhang, Jihui; Lam, Siu-Ping; Li, S.X.; Tang, N.L.; Yu, M.W.M.; Li, A.M.; Wing, Yun-Kwok

doi:10.1016/j.pain.2011.12.003

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Volume 153, Issue 3 , Pages 666-673, March 2012

Insomnia, sleep quality, pain, and somatic symptoms: Sex differences and shared genetic components

Jihui Zhang
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
Siu-Ping Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
S.X. Li
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
N.L. Tang
- Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
M.W.M. Yu
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
A.M. Li
- Department of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
Yun-Kwok Wing
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
- Corresponding author. Address: Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China. Tel.: +852 26367748; fax: +852 26475321.

Received 26 April 2011; received in revised form 5 November 2011; accepted 6 December 2011. published online 25 January 2012.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

TOC summary

A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population.

Abstract

This study investigated the sex differences, and the shared genetic and environmental factors underlying the associations of sleep disturbances (insomnia and sleep quality) with pain and somatic symptoms in both adolescents and middle-aged adults. We recruited 259 adolescents (69 with current insomnia) and their parents (256 middle-aged adults, 78 with current insomnia). Insomnia severity and sleep quality were measured by the Insomnia Severity Inventory (ISI) and Pittsburgh Sleep Quality Index (PSQI), respectively. Pain and somatic symptoms were measured by the Somatic Symptom Inventory and Visual Analogue Scale for overall pain. Subjects with insomnia scored higher on all measures of pain and somatic symptoms than non-insomnia patients, in both adolescents and adults (P<.001). Both pain and somatic measures were associated with ISI and PSQI scores after controlling for age, sex, depressive and anxiety symptoms. There was an interaction effect between insomnia and female sex on pain and somatic symptoms (P<.05), especially in adults. Pain and somatic symptoms ran in family with moderate heritability (range h²=0.15–0.42). The phenotypic associations of ISI and PSQI with pain and somatic measures were both contributed by genetic (range p_G=0.41–0.96) and environmental (range p_E=0.27–0.40) factors with a major genetic contribution. In summary, insomnia and poor sleep quality are closely associated with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population. A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms.